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5/7/12
BASE OF SKUL
Dr Edward ChegeR1
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OUTLINE
•
Introduction• Clinical significance
• Developmental anatomy
• Anterior skull base
• Central skull base
•
Posterior skull base
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Clinical significanc
•
Fracture base of skull.• Trans-sphenoidal surgery.
• Intracranial disease spread thro
foramina.
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Developmental anato• Desmocranium
• Chondrocranium
• Ossification
• Fusion of ossification centers
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Plain radiographs
Views1. Lateral view
ATLS
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Submento-vertical•
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Sella turcica view
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Townes view (fronto-occipital 30o c
Sella turcica projected over
foramen Magnum.
Lower radiation dose
to sensitive structures
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Anterior skull baseFloor of anterior cranial fossa
Development
Ø Multiple ossification centers main
endochondral
Ø
Ossification progresses from poste
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Anterior skull baseLimits
Ø Anterior: Frontal boneanteromedially
Ø Posterior: Planum
sphenoidale and Sphenoid
ridge posteriorly
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Anterior skull baseForamina and fissures
1. Foramen caecum
anterior to crista galli
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Anterior skull base2. Anterior ethmoidal foramen
anterior ethmoid artery vein & nerve
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Anterior skull baseØ
Posterior ethmoidal foramepost ethmoid artery vein & nerve
Ø Foramina of cribriform plate
Afferent fibers to olfactory bulb
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Anterior skull baseStructures
Frontal lobe
Olfactory bulb and CN 1,
Optic nerve
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Central skull baseFloor of middle
cranial fossa
Limits
Ø Anterior: Tuberculum sellae,lesser wing of sphenoid
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Central skull baseForamina
Optic canal
Ø CN 2
Sup orbital fissureØ CN 3, 4, 5(i), 6,
Ø superior ophthalmic vein
Inferior orbital fissure
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Central skull baseForamina Cont’d
Carotid canal
Internal carotid and
sympathetic plexus
Foramen rotudum
To pterygoid fossa
Maxillary branch of CN 5
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Central skull baseForamina
Foramen ovale
Mandibular branch of CN 5
Foramen spinosumMiddle meningeal artery and vein
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Central skull baseForamina
Foramen lacerum
Cartilaginous floor of horizontal
internal carotid artery canal
Vidian canal
Vidian artery and nerve
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Central skull baseNormal Variants
1. Persistent craniopharyngeal canal
Remnant of Rathkes pouch
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Central skull baseExtensive pneumatization of sphen
sinus
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Central skull baseForamen of Vesalius
transmits emissary vein from cavernoto pterygoid plexus
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Posterior skull basBones
1. Temporal bones posterior to spheridge
2. Occipital bone
1. Basilar part
2. Condylar part
3. Squamous part
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Posterior skull basForamina
1. Internal acoustic meatusIn posterior part of temporal bone
porus acusticus
CN 7 & 8, labyrinthine artery
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Posterior skull bas2. Jugular foramen
Pars nervosa; CN9 Jacobson nerve, Inferior petPars vascularis; CN 10 & 11, Arnold nerve, jugposterior meningeal artery
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Posterior skull bas3. Groove for sigmoid sinus
In medial mastoid temporal bone
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Posterior skull bas4. Hypoglossal canal
In condylar occipital bone
CN12
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Posterior skull basForamen magnum
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Posterior skull bas
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Role of ultrasoundØ Fetal assessment
Ø Normograms of ASBL, PCFL in assof brain development
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ReferencesØ Alfred L. Weber; History of Head
Neck Radiology: Past, PresentFuture
Ø Hansberger, Osborn et al; Diagno
and Surgical Imaging AnatomyØ N.M. Roelfsema; Three-dimensio
ultrasound study of fetal cran
anatomy International Society o