ISSN 1612-3352

Editors in Chief

Prof. Dr. Claus F. Claussen, Neurootological Research Institute of the Research Society for Smell, Taste, Hearing and Equilibrium Disorders at Bad Kissingen (4-G-F). Bad Kissingen, Germany.
Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.

Production Managers

Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.


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Neurootological findings in patients, suffering from occipital skull fractures

Abstract

Skull traumas play an important roll in neurootological expertise writing. Skull traumas may occur at the rhinobasis, i.e. frontally, at the otobasis, i.e. laterally as well as from behind, i.e. occipitally. For this paper we have elected 26 cases of occipital skull fractures which were verified by radiology. It is known that the shockwaves of an occipital skull fracture does not only lead to local tissue damages in the neighbouring occipital lobe and/or cerebellum. But pressure waves may induce contrecoup effects at the frontal lobe and at the brainstem.

Due to the brainstem involvement we find a higher rate of vertigo complaints and of vertigo releasing factors in our randomly selected sample of 26 cases. The nausea complaints are lagging behind the vertigo complaints. The vertigo complaints are long-lasting. There also is an elevated percentage of oculomotor regulating disturbances with double vision and oscillopsia. The elevated percentage of anosmia must be explained by a contrecoup effect. Approximately half of the sample is suffering from tinnitus and subjective hearing losses.

In equilibriometry  by means of polygraphic ENG we found much elevation in spontaneous nystagmus in lying position more then in sitting position. By means of the trinary coded caloric Claussen butterfly we detected 55% of pathology. The trinary stepping CCG is not as sensitive as it only detected in 47,3% of pathology. The complaints about a subjective hearing loss are more intensively objectivated by speech audiometry than by pure tone audiometry.

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