Vascular injury following lateral skull base trauma: diagnosis and management

Vascular injury following skull base trauma can arise from blunt and penetrating injuries. This can pose life-threatening complications. Timely diagnosis and management is therefore crucial to prevent or mitigate the risk of associated neurovascular sequelae. In this chapter, we discuss the basic principles of skull base anatomy and associated neurovascular structures. We then explore the etiology and natural history of key vascular injuries including dissection, pseudoaneurysms, and fistula formation. The evaluation, diagnosis, and management are outlined for each pathology. This chapter concludes by providing a general outline of the clinical decision-making process including history and exam, and choice of imaging modalities.