Depressed Skull Fracture Surgical Management and Outcome among Head Injury Patients: Experience at Tertiary Care Hospital
DOI:
https://doi.org/10.36552/pjns.v27i4.937Keywords:
Skull depressed fracture, compound depressed fracturesAbstract
Objective: To evaluate outcomes in patients with managed depressed skull fractures operatively having head injuries.
Methods: This study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro. We analyzed 76 patients who underwent operative management for skull fractures. Patient selection included both children and adults with skull fractures evident on CT brain scans using bone windows.
Results: Our study included 76 patients, with 48 males and 28 females, and a mean age of 28.68 ± 10.33 years. Among them, 45 (59.21%) were under 30 years old, and the highest incidence of depressed skull fractures occurred in the 21 – 30 age group. Road traffic accidents were the leading cause, accounting for 42 (55.25%) cases, while falls from heights contributed to 24 (31.57%) cases, and 7 (9.21%) resulted from objects falling on the patients.
Conclusion: Patients with head injuries can be fatal if not managed promptly. Neglecting the management of a depressed fracture can also impact the outcome in these cases and lead to a series of complications.
References
Choi Y, Kim EY, Sun J, Kim HK, Lee YS, Oh BM, Park HY, Leigh JH. Incidence of depression after traumatic brain injury: a nationwide longitudinal study of 2.2 million adults. Journal of neurotrauma. 2022;39(5-6):390-7.
Salia SM, Mersha HB, Aklilu AT, Baleh AS, Lund-Johansen M. Predicting dural tear in compound depressed skull fractures: a prospective multicenter correlational study. World Neurosurgery. 2018;114:e833-9.
Satardey R, Balasubramaniam S, Pandya J, Mahey R. Analysis of factors influencing outcome of depressed fracture of skull. Asian journal of neurosurgery. 2018;13(02):341-7.
Amir S. Depressed skull fracture: surgical management and outcome. Journal of Medical Sciences. 2017;25(3):336-9.
Narejo MA, Akbar A, Shaikh MA, Ali MM, Hussain S, Arain KS. The Link between Skull Fracture and Extradural Hematoma in Head Injury Patients who came to a Tertiary Care Hospital in Pakistan. 2022;16(1): 1400-3.
Asif M, Rehman WA, Serwar S, Younas H, Younas F. Pediatric head injury: A study of 120 cases. Pakistan Journal of Neurological Surgery. 2021;25(2):180-6.
Chawla H, Yadav RK, Griwan MS, Malhotra R, Paliwal PK. Sensitivity and specificity of CT scan in revealing skull fracture in medico-legal head injury victims. The Australasian medical journal. 2015;8(7):235.
Tripathi AK, Kansal S, Murthy K, Kumar A, Baid A. Is the Elevation of Depressed Calveria over Superior Sagittal Sinus (SSS)-(No Men Land) Rightly Contraindicated. Ind J Anat Sur Head Neck Brain. 2016;2(1):32-4.
Rolekar NG. Prospective study of outcome of depressed skull fracture and its management. Int J Medical Sci Public Health. 2014;3(12):1540-5.
Shah HA, Mehta NH, Mehta SH, Ward M, McBriar JD, D’Amico RS. Characterizing Complications Associated with Skull Clamps: A Review of the Manufacturer and User Facility Device Experience database. Clinical Neurology and Neurosurgery. 2023;108043.
Kalhoro A, Samad A, Rehman L. Frequency of traumatic cerebrospinal fluid rhinorrhoea in mild head injury with pneumo-encephalus. Pak J Surg. 2018;34(3):215-8.
Prakash A, Harsh V, Gupta U, Kumar J, Kumar A. Depressed fractures of skull: an institutional series of 453 patients and brief review of literature. Asian journal of neurosurgery. 2018;13(02):222-6.
Satardey R, Balasubramaniam S, Pandya J, Mahey R. Analysis of factors influencing outcome of depressed fracture of skull. Asian journal of neurosurgery. 2018;13(02):341-7.
I?ik HS, Bostanci U, Yildiz Ö, Özdemir C. Traumatic Posterior Fossa Epidural Hematomas in Childhood: Report of 6 Cases. Journal of Neurological Sciences (Turkish). 2011;28(2):294-9.
Paiva WS, Andrade AF, Mathias Júnior L, Guirado VM, Amorim RL, Magrini NN, Teixeira MJ. Management of supratentorial epidural hematoma in children: report on 49 patients. Arquivos de neuro-psiquiatria. 2010;68:888-92.
Al-Derazi T, Das K, Gupta PK, Thajudeen BA, Ravindra J. Management strategy of depressed skull fractures. Pan Arab J Neurosurg. 2008;12:80-5.
Faried A, Kurniawan CB, Halim D, Arifin MZ. A rare case of depressed skull fractures at the anterior cranial fossa associated with communicating hydrocephalus resulting a progressive visión loss. Interdisciplinary Neurosurgery. 2019;17:119-23.
In A, Stopa BM, Cuoco JA, Olasunkanmi AL, Entwistle JJ. Depressed skull fracture compressing eloquent cortex causing focal neurologic deficits. Brain Injury. 2023;37(4):352-5.
Kaya ?, Yakar H, Kesen E. Low-cost 3-d-printer–assisted personalized cranioplasty treatment: A case series of 14 consecutive patients. World Neurosurgery. 2023;175: e1197-e1209.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Aurangzeb Kalhoro, Muhammad Hamid Ali, Vashdev Khimani, Raiz Ahmed Raja, Mahesh Kumar LuhanoThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
