FREQUENCY OF EXTRADURAL HAEMATOMA IN PATIENTS WITH LINEAR SKULL FRACTURE
AbstractBackground: Apparently normal looking patients after traumatic brain injury can have serious neurological deterioration, and one of the common causes of such deterioration is extradural haematomas. This study was conducted to determine the frequency of extradural hematoma and common types of trauma leading to it among patients presenting with skull fracture due to head injury. Methods: This cross-sectional study was conducted in the department of Neurosurgery Ayub Medical College, Abbottabad from June 2011 to June 2012. All patients who were suspected to have Skull fracture on X-ray skull, during the study period, were included in study after informed consent and later on CT-Scan brain was done to see for extradural hematoma. Findings were recorded on a predesigned pro forma including demographic data, radiological findings and the type of head trauma. Results: Out of 114 patients 85 (74.5%) were males and 29 (225.4%) were females. Age ranged from 2 to 70 years (18.23±16.5 years). Among these patients the most important cause of head injury was fall from height in 65(57%), followed by road traffic accidents in 39 (34.2%), and assault in 10 (8.8%) patients. The most common site of fracture was parietal in 49 (43%) of patients, followed by frontal bone in 28 (24.6%) of patients, occipital bone in 24 (21.1%) of patients, and temporal bone in 23 (20.2%) of patients. Frequency of extradural hematoma among linear skull fracture was in 34 (29.8%) patients. Extradural hematoma was most common with parietotemporal linear skull fractures (73.5%). Conclusion: Extradural haematoma occurs commonly with linear skull fractures, so patients with linear skull fracture should be properly evaluated with CT brain.Keywords: Head injury, extradural haematoma, linear skull fracture.
Moppet K. Traumatic Brain injury: assessment, resuscitation and early management. Br J Anesth 2007;99(1):18–31.
Greenwald RM, Gwin JT, Chu JJ, Crisco JJ. Head Impact Severity Measures for Evaluating Mild Traumatic Brain Injury Risk Exposure. Neurosurgery 2008;62(4):789–98.
Price DD, Wilson SR. Epidural Haematoma.[Online] 2009, [Cited On] May 2010. Available From: URL: http://emedicine.medscape.com/article/824029-media.
Agrawal A, Agrawal CS, Kumar A, Adhikari S. Outcome of traumatic extradural haematoma managed surgically: our experience. Nigerian J Ortho Trauma 2007;6(2):74–6.
Hussain M, Ojha B, Chandra A, Singh A, Singh G, Chugh A, et al. Contralateral Motor Deficit in Extradural Hematoma : Analysis of 35 Patients. Indian J Neurotrauma 2007;4(1):41–4.
Babu ML, Bhasin SK, Kumar A. Extradural Hematoma- An Experience of 300 Cases. JK Science 2005;7(4):205–7.
James R, Gill M, Lara B, Goldfeder M, Vernon A, Andrea C et al. Fatal Head Injury in Children Younger Than 2 Years in New York City and an Overview of the Shaken Baby Syndrome. Arch Path Lab Med 2009;133(4):619–27.
McIntosh AS, McCrory P, Finch CF, Wolfe R. Head, face and neck injury in youth rugby: incidence and risk factors. Br J Sports Med 2010;44:188–93
Vilela M, West GA. Traumatic Intracranial Hematomas. In; Rengachary SS, Ellenbogen RG (edi) Principles of Neurosurgery. 2nd ed. USA; Elsevier 2005;361–2.
Stewart CR, Salmon JF, Domingo Z, Murry ADN. Proptosis as a presenting sign of Extradural Hematoma. British J Opthalmol 1993;77:179–80.
Asanin B. Traumatic Epidural Hematomas in Posterior Cranial Fossa. Acta Clin Croat 2009;48:27–30.
Mushtaq, Rehman L, Zaman KU Association of Outcome of Traumatic Extradural hematoma with Glasgow Coma Scale and Hematoma Size. Ann Pak Inst Med Sci 2010;6(3):133–8.
Hossain MZ, Mondle MS, Hoque MM. Depressed Skull Fracture: Outcome of Surgical Treatment. J Teachers Assoc 2008;21(2):140–6.
Khan IU, Nadeem M. There is high incidence of Skull Fracture associated with Extradural Haematoma in patients with Head injury. Rawal Med J 2008;33:228–30.
Khan MJ, Shaukat A, Khalid M, Aziz MA. Surgical Management and outcome analysis of Extradural Hematoma at Combined Military Hospital Rawalpindi. Pak Arm Forc Med J 2009;59(1):70–3.
Sunay YM, Mahmut A, Gursel C, Yasemin GB, Muzaffer A. The Correralation between Skull fractures and Intracranial lesions due to traffic accidents. Am J Foren Med Pathol 2003;24(4):339–45.
Servadei F, Ciucci G, Pagano F, Rebucci GG, Ariano M, Piazza G, Gaist G. Skull fracture as a risk factor of intracranial complications in minor head injuries: a prospective CT study in a series of 98 adult patients. J Neurol Neurosurg Psychiat 1988;526–8.
Chattopadhyay S, Tripathi C. Skull fracture and haemorrhage pattern among fatal and non-fatal head injury assault victims- a critical analysis. J Inj Violence Res 2010;2(2):99–103.
Strong EB, Pahlavan N, Saito D. Frontal Sinus fractures: A 28-year retrospective review. J Otolaryngol Head Neck Surg 2006;135(5):774–9.
Prashant G, Atul K, Amit D, Kumkum G, Madhu B, Gouri G, et al. CT Scan Findings and Outcomes of Head Injury Patients: A Cross-Sectional Study. J Pak Med Stud 2011;1(3):78–82.
Nath HD, Rahman ML, Rahman Z, Din KU, Sahajahan M. Surgical Outcome of Patients with Extradural hematoma at the department of Neurosurgery in Chittagong Medical College Hospital: A Study of 30 Patients. J Chittagong Med Coll Teachers Assoc 2008;19(1):8–10.
Bavil MS. Autopsy Findings in Patients with Severe Head Injury. Res J Med Sci 2008;2(4):190–2.
Igun GO. Predictive Indices In Traumatic Intracranial Haematomas. East Afr Med J 2000;77(1):9–12.
Kumar A, Lalwani S, Agrawal D, Rautji R, Dogra TD. Fatal Road Traffic Accidents and their relationship with head injuries: An epidemiological survey of five years. Indian J Neurotr 2008;5(2):63–7.
Pathak A, Desania NL, Verma R. Profile of Road Traffic Accidents and Head injury in Jaipur (Rajasthan). J Indian Acad Forensic Med 2004;30(1):6–9.
Amin Z, Sayuti R, Kahairi A, Islah W, Ahmed R. Head Injury with Temporal Bone fracture: One Year Review of Case Incidence, Causes, Clinical Features and Outcome. Med J Malaysia 2008;63(5):373–6.
Serdar H, Bostanci U, Yildiz O, Ozdemir C, Traumatic Posterior Fossa Epidural Hematoma in Childhood: Report of 6 cases. J Neurolog Sci 2011;28(2):294–9.
Paiva WS, Andrade AFD, Junior LM, Guirado VMDP, Amorim RL, Magrini NN, et al. Management of Supratentorial Epidural Hematomas in children. Arq Neuropsiquiatr 2010;68(6):882–92.
Roka YB, Kumar P, Bista P, Sharma GR, Adhikari D. Traumatic Posterior Fossa Extradural Hematoma. J Nepal Med Assoc 2008;7(172):174–8.
Ozkan U, Kemaloglu S, Ozates M, Guzel A, Tatli M. Analyzing Extradural Hematoma: A Retrospective Clinical Investigation. Dicle Tip Dergisi 2007;34(1):14–9.
Hanci M, Uzan M, Kuday C, Sarioglu AL, Akar Z, Canbaz B, et al. Epidural Hematomas in Infancy and Childhood: Report of 54 cases. Turkish Neurosurg 1994;4:73–6.
Chowdhury SNK, Hanif A, Islam KMT, Mahmood E, Hossain SS. Extradural Hematoma in Children: Surgical Experiences and Prospective Analysis of 138 cases. J Paediatr Surg Bangladesh 2010;1(1):19–24.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.