To Determine the Frequency of Dural Tear in Patients Presenting with Depressed Skull Fracture
An Experience of 96 Cases in a Tertiary Care Hospital
DOI:
https://doi.org/10.37762/jgmds.4-1.28Keywords:
Depressed skull fracture, Contusion, Head trauma, Frequency, Dural tearAbstract
OBJECTIVE
The objective of this study was to determine the frequency of dural tear in patients with depressed skull fractures.
MATERIAL and Method
This cross-sectional study was conducted in department of Neurosurgery Pakistan institute of Medical Sciences Islamabad from January 2010 to December 2011. All patients of either gender with depressed skull fracture above one year of age were included in the study. CT brain with bone window done in all patients. Per-operative dura in the region of depressed skull fracture was closely observed for any dural tear. The data collected on pre designed proforma. and analyzed using SPSS version 20.0
RESULTS
A total of 96 patients were recruited in the study out of which 58(60.4%) were male and 38(39.5%) were female. Male to female ratio was 1.5:1. And mean age was 19.23 + 2.54 years. The most common location of depressed skull fracture was parietal 37(38.5%), followed by frontal in 27(28.1%), 15(15.6%)in temporal region,13(13.5%) in occipital region and only 4(4.1%) located in posterior fossa. Dural tear was present in 33(34.3%) while in 63(65.6%) it was absent. Other finding associated with depressed skull fracture per operatively were extradural hematoma in 16(16%), subdural hematoma in 11(11.4%), contusion in 16(16.6%) and pneumoencephalus was observed in 20(20.8%) cases.
CONCLUSION
The frequency of dural tear in DFS is quite high, so one should be vigilant to identify the defect and repair it properly to minimize post operative complications.
Downloads
Metrics
References
Parel PA.Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. Br. Med. J 2008;336:425-9 DOI: https://doi.org/10.1136/bmj.39461.643438.25
Emejulu JKC, Shokunbi MT, Malomo AO, Adeleyo A. Causes of delay in the definitive treatment of compound depressed skull fracture: A five year study from Nigeria. East. Cent. Afr. J. Surg 2006;12:116-22
Hoyt DB, Holcomb J, Abraham E, Atkins J, Sopko G.Working group on trauma research programe summary report: National heart lung blood institute( NHLBI), National institute of genereal medical sciences ( NIGMS). And National institute of Neurological disorder and stroke ( NINDS) of the National institute of Health(NIH), and the Department of Defence(DOD). J Trauma 2004;57(2):410-5 DOI: https://doi.org/10.1097/00005373-200408000-00038
Rodrigurez ED, Stanwix MG, Nam AJ, et al. twenty six year experience treating frontal sinus fracture: a novel algorithm based on anatomical fracture pattern and failure of conventional techniques, Plastic Reconstr Surg 2008;122(6):1850-66 DOI: https://doi.org/10.1097/PRS.0b013e31818d58ba
Khan AH. Depress skull fracture epidemiology and avoidance of its complication. Thesis, Punjab university ,Lahore,2004
Ali M, Ali L. Roghani, IS. Surgical management of depress skull fracture. JPMI 2003;17: Record 23
Rehman L, Ghani E, Hussain A, etal. Infection in compound depress fracture of skull. J Coll physicians surg Pak.2007;17(3):140-3
Tseng WC, Shih HM, Su YC, Chen HW,Hsiao KY, Chen IC.The association between skull bone fractures and outcome in patient with sever traumatic brain injury. J Trauma 2011;71(6):1611-4 DOI: https://doi.org/10.1097/TA.0b013e31823a8a60
Mehdi SA, Ahmad B, Dogar IH, Shoukat A. Depressed skull fracture; interrelationship between ct evaluation of and its clinical findings. Prof. Med J 2010;17(4):616-22 DOI: https://doi.org/10.29309/TPMJ/2010.17.04.3009
Manish J, MathewH, Nupur P, Amey R, Savardekar, Sarbesh T, Malla B. Midline depressed skull fracture presenting with quadriplegia: A rare phenomenon. Pu Surg Neurol Int 2017;8:39-46 DOI: https://doi.org/10.4103/sni.sni_431_16
Al-Haddad SA, Kirollos R A 5 year study of the outcome of surgically treated depressed skull fracture: Ann R Coll Surg Engl.2002;84(3):196-200
Fitzsimmons-Francis C, Morris P, Prehospital care: Triage and trauma scoring. Surg int 2001;52:25
Nayak PK, Mahapatra AK. Primary reconstruction of depressed skull fracture-the changing scenioro. Indian J Neurotrauma 2008;5(1):35-8 DOI: https://doi.org/10.1016/S0973-0508(08)80026-3
Hussain R, Khan B, Azam F, et al. outcome of surgically managed Depress Skull Fracture in Tertiary Care Hospital.Pak J.Neurol.surg.2013;17(2):168-170
Nazer H Quresh. Skull fracture Department of Neurosurgery, university of Arkansas for Medical sciences.2008
Hossain MZ, Mondle MS, Hoque MM. Depress skull fracture of the skull: outcome of surgical treatment. TAJ 2008;21(2):140-6 DOI: https://doi.org/10.3329/taj.v21i2.3794
Igum GO. Predictive indices in traumatic intracranial hematomas. East Afr Med J 2000;77(1):9-12 DOI: https://doi.org/10.4314/eamj.v77i1.46363
Yavuz MS, Asirdizer M, Cetin G, Gunay Balci Y,Altinkok M. The co relation between skull fractures and intracranial lesion due to traffic accidents. Am J Forensic Med Pathol 2003;24(4):339- 45 DOI: https://doi.org/10.1097/01.paf.0000103011.14578.c3
Langolis JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumat brain injury: a brief overreview. J Head trauma Rehabil 2006;21(5):375-8 DOI: https://doi.org/10.1097/00001199-200609000-00001
Braakman R. Depressed skull fracture: data, treatment and follow-up in 225 consecutive cases J Neurol Neurosurg Psychiatry 1972;35(3):395-402 DOI: https://doi.org/10.1136/jnnp.35.3.395
Muhammag G, Aurangzeb A, Khan S, Suhail R et al. dural tears in patients with depressed skull fractures. J Ayub Med Coll Abbottabad 2017;29(2):311-5
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Sohail Amir, Dr., Syed Amir Shah, Dr., Khaleeq -Ur- Zaman, Dr.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.