Depressed skull fractures may require surgery to lift the bones off the brain if they are pressing on it by making burr holes on the adjacent normal skull. Diastatic fracture
Diastatic fractures occur when the fracture line transverses
one or more sutures of the skull causing a widening of the suture. While this type of fracture is usually seen in infants and young children as the sutures are not yet fused it can also occur in adults. When a diastatic fracture occurs in adults it usually affects the lambdoidal suture as this suture does not fully fuse in adults until about the age of 60. Most adult diastatic fractures are caused by severe head injuries. Due to the trauma, diastatic fracture occurs with the collapse of the surrounding head bones. It crushes the delicate tissue, similarly to a depressed skull fracture.Diastatic fractures can occur with different types of fractures and it is also possible for diastasis of the cranial sutures to occur without a concomitant  fracture. Sutural diastasis may also occur in various congenital disorders such as cleidocranial dysplasia and osteogenesis imperfecta. Basilar fracture
Basilar skull fractures are linear fractures that occur in the floor of the cranial vault (skull base), which require more force to cause than other areas of the neurocranium. Thus they are rare, occurring as the only fracture in only 4% of severe head injury patients.
Palmar erythema is reddening of the palms at the thenar and hypothenar eminences. : 139

Causes
It is associated with various physiological as well as pathological changes, or may be a normal finding:

Portal hypertension
Chronic liver disease (including chronic hepatitis)
Pregnancy
Polycythemia
Thyrotoxicosis
Rheumatoid arthritis (especially in patients with polycythaemia)
Eczema and psoriasis
Deep telangiectasias
Coxsackievirus A infection (Hand, foot and mouth disease)
Rocky Mountain spotted fever
Secondary syphilis
Kawasaki disease
Adverse drug reaction: palmoplantar erythrodysesthesia (acral erythema)Because circulating levels of estrogen increase in both cirrhosis and pregnancy, estrogen was thought to be the main cause for the increased vascularity. More recently, nitric oxide has also been implicated in the pathogenesis of palmar erythema. Diagnosis
Palmar erythema has no specific treatment. Management is based on the  underlying cause. When its cause is treated then patients get relief. If it is attributable to a particular drug then the drug should be withdrawn. See also
Toxic erythema
List of cutaneous conditions

References


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