1. IMAGING OF THE SKULL, FACIAL BONES, AIR
SINUSES, UPPER AND LOWER JAW, CRANIAL
BONES, AGE -RELATED FEATURES. TRAUMATIC
INJURES, CT, MRI AND RADIOGRAPHY AXIAL,
CORONAL, SAGITTAL SECTIONS
2. • Bones of the skull
• The skull, also called the cranium, is the bony structure of the head. Two sets of bones comprise the skull:
• Cranial bones. Bones that protect and enclose the brain.
• Facial bones . Bones that provide the framework for the face and mouth.
• All bones making up the skull are attached to each other by immovable joints, except for the jaw bone, which is attached via a
movable joint.
• The cranium holds and protects the brain. It is made up of 8 bones. They are:
• Frontal bone
• Parietal bones (one on each side)
• Temporal bones (one on each side)
• Ethmoid bone
• Sphenoid bone
• Occipital bone
• The skeleton of the face has 14 bones, which include those that make up the jaws, cheeks, and nasal area.
9. • Why a skull X-ray is done
• Prior to your X-ray, your doctor will tell you the exact
reason for your X-ray. A skull X-ray is typically done after
a traumatic head injury. The X-ray allows your doctor to
inspect any damage from the injury.
• Other reasons you may undergo a skull X-ray include:
• decalcification of the bone
• deformities in the skull
• fractures of the skull or facial bones
• frequent headaches
• infection of the bones of the skulls
• occupational hearing loss (caused by your job)
• tumors
Depending on what the X-rays show, your doctor may
order other follow-up imaging scans, such as
an MRI or CT scan.
11. THE PA(POSTERO-ANTERIOR) VIEW SHOWS THE
FRONTAL BONES, FRONTAL AND ETHMOID SINUSES, NASAL CAVITY, SUPERIOR ORBITAL
RIMS, AND MANDIBLE
PA skull radiograph. The following
structures are visible: falx cerebri (Fx), frontal sinus (Fs),
internal
auditory canal (Ia), sphenoid sinus (Ss), and maxillary sinus
(Ms).
13. THE LATERAL VIEW DEMONSTRATES THE FRONTAL, PARIETAL, TEMPORAL, AND OCCIPITAL
BONES, THE MASTOID REGION, THE SELLA TURCICA, THE ROOFS OF THE ORBITS, AND THE
LATERAL ASPECTS
OF THE FACIAL BONES
Lateral radiograph of the skull. The following structures
are visible: coronal suture (arrowheads), occipital suture
(open arrow),
middle meningeal vascular grooves (straight arrows), sella
turcica (St), and
mastoid air cells (M).
18. AGE RELATED FEATURES
.
Axial bone algorithm CT images (1 mm thick) of the
lambdoid sutures (arrows) in patients of different ages. (a)
In a 2-day-old neonate, the sutures measure 4-7 mm,
have ill-defined margins, and can appear asymmetric. (b)
By 6 weeks, the size of the sutures has decreased
dramatically. (c) By 13 months, the suture edges are
better defined.
19. AGE RELATED FEATURES
Axial CT scan (A), anterolateral (B) and superior (C)
3DCT volume rendered images show trigonocephaly
from premature / abnormal fusion of the metopic
suture (arrow). Note marked flattening of the frontal
bones
21. SKULL TRAUMA
A lateral skull radiograph of a child who
was struck in the head with a baseball
bat. The radiograph demonstrates a
depressed fracture of the occipital bone.
“ Female 5 year old with head injury after a fall from
her bicycle and findings of frontal bone fracture that
extends to the roof of the left orbit,...”
22. BASILAR SKULL FRACTURE
• A basilar skull fracture is a break of a bone in the base of the skull.[1] Symptoms may
include bruising behind the ears, bruising around the eyes, or blood behind the ear
drum.[1] A cerebrospinal fluid (CSF) leak occurs in about 20% of cases and can result in fluid
leaking from the nose or ear.[1] Meningitis is a complication in about 14% of cases.[2] Other
complications include cranial nerve or blood vessel injury.[1]
• They typically require a significant degree of trauma to occur.[1] The break is of at least one of
the following bones: temporal bone, occipital bone, sphenoid bone, frontal bone, or ethmoid
bone.[1] They are divided into anterior fossa, middle fossa, and posterior
fossa fractures.[1] Facial fractures often also occur.[1] Diagnosis is typically by CT scan.[1]
23. BASILAR SKULL FRACTURE CT
A subtle temporal bone
fracture as seen on CT in
a person with a severe
head injury
A basilar skull fracture as seen on
CT
Skull base fracture.A, A compound fracture
through the left occipital bone and petrous
apex extending into the sphenoid sinus
(arrows). B, High-resolution reconstruction
showing involvement of the left carotid
canal (arrow) with the presence of a locule
of air within the carotid canal (thin arrow)
and partial opacification of the middle ear
cavity (asterisks).
