Anticipation of Dural Tear in Patients with Blunt Head Trauma

Elsherbini, Mohamed; Elmokadem, Ali H.; Badr, Hatem; Khalil, Abdalla

doi:10.4236/ojmn.2022.123014

Cited by 2 publications

(2 citation statements)

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“…While primary TBI cannot be prevented, a secondary, deadly sequel can be when recognized and treated at the right time and with the right approach. Due to increased male involvement in driving and conflict (the main reason in our study), it is projected that male injuries will outnumber female injuries in all categories of head trauma 22 .…”

Section: Discussionmentioning

confidence: 93%

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Magnitude of dural tear and its associated factors among patients with depressed skull fracture

Molla,

Alemu,

Kassa

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Trauma is a huge problem seen in developed countries as well as developing countries. Head injury is a major factor responsible for mortality in young populations. Up to 6% of all head injuries and 11% of severe head traumas might result in a depressed skull fracture (DSF), a catastrophic injury. The aim of this study was to determine the prevalence of dural tear and to identify its predictors.. Method: A retrospective review of medical records of all patients operated on for depressed skull fractures at the University Comprehensive Specialized Hospital from January 1, 2021, to January 1, 2023 G.C. was conducted. A total of 163 patients were included in the study. Results: A total of 163 patients (136 men (83.4%) and 27 women (16.6%) had a mean age of 23.9 with a standard deviation of 14.8 (range from 3-65). Patients with penetrating injuries (missiles, axes) were excluded. The majority, 153 (93.9%) of the patients, were younger than 50 years of age. Physical assault accounted for 102 (62.5%) of the cases. Of the assaulted cases, 62 (38%) were assaulted by stone, 32 (19.6%) by stick, and 8 (5%) by other objects (beer bottle and shovel). Bleeding from the trauma site in 124 (76.1%), headache in 76 (46.6%), loss of consciousness in 75 (46%), and vomiting in 72 (44.2%) were the most common presentations. Based on the Glasgow Coma Scale (GCS), 123 (75%) of patients had mild head injuries. Based on the site of fracture, frontal depressions are the most common (61, 37.4%), followed by parietal depressions (53, 32.5%). With regard to the associated injuries, brain contusion was seen in 52 (32%), epidural hematoma in 26 (16%), subdural hematoma in 3 (1.8%), and IVH/SAH in 3 (1.8%). The median duration of presentation was 15 hours, with an IQR of 8–24 (1–96 hours). From the multivariable logistic regression, brain contusion and epidural hematoma were significantly associated with dural tear. Conclusion: The rules of our culture are reflected in the higher incidence of accidents and fractures among men. Physical assault, particularly with stones, was the most common cause of DSFs. Frontal depressions were the most common site of fracture, followed by parietal fractures. Brain contusion and epidural hematoma were significantly associated with dural tears. School-aged children are more vulnerable to injuries from horse or donkey kicks and falls.

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Section: Discussionmentioning

confidence: 93%

“…According to one study, pneumocephalus, cerebral contusion, and depth of depression were the most predictive parameters for dural tears in patients with DSFs 22 , 23 . In our study, contusions and EDHs were predictive of dural tears.…”

Section: Discussionmentioning

confidence: 99%