Computerized tomography assessment of cranial and mid-facial fractures in patients following road traffic accident in South-West Nigeria

Abiodun, Adeyinka; Agunloye, Atinuke M; Yvonne, Osuagwu

doi:10.4103/1596-3519.96860

Cited by 12 publications

(8 citation statements)

References 19 publications

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“…Various studies have revealed middle cranial fossa (MCF) to be most commonly involved in BSF which has been attributed to thin bones in MCF consisting of multiple foramina. [ 12 19 24 ] However, few others have reported ACF to be most common site of BSF. [ 18 25 ] In our study, fractures of ACF (50%) followed by multiple fractures (38.14%) and MCF (10.82%) were more common [ Table 3 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis and Clinical Importance of Skull Base Fractures in Adult Patients with Traumatic Brain Injury

Sivanandapanicker

Nagar

Kutty

et al. 2018

Journal of Neurosciences in Rural Practice

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Aims and Objectives:Basal skull fracture (BSF) is rare in head injury (HI) patients and occasionally goes unnoticed which may lead to cerebrospinal fluid (CSF) fistula. With changing trends in HI, there is a need to reassess incidence and pattern of BSF pattern, CSF leak, meningitis, and management protocol, especially in this part of the world where detailed literature is lacking.Subjects and Methods:We closely followed adult patients admitted with BSF in our institute between January 2013 and December 2014. Associated clinical features were recorded. In case of CSF leak, detailed CSF study was done and patients were managed accordingly. Patients with persistent CSF leak were managed surgically.Results:During the study period, 194 of 5041 HI patients had evidence of BSF (3.85%). BSF was most commonly associated with moderate-to-severe HI (73.19%). About 81.44% patients were male and 29.9% were <30 years. Most common cause was road traffic accident (84.54%). Isolated anterior cranial fossa (ACF) fracture was most common (50%). About 63.92% patients had raccoon eyes. Forty-three patients had CSF leak with CSF rhinorrhea being more common. Culture of only 5 patients suggested bacterial meningitis. CSF leak lasted for more than 10 days in 8 patients, of which 4 patients required surgical repair.Conclusions:BSF is rare in victims of HI. It is more common in young adult males. ACF fractures are most common in our setup. Clinical signs of BSF are supportive but not definitive; high resolution computed tomography head is gold standard to detect BSF. CSF leak is rare and most of the cases can be managed conservatively. Leak persisting more than 7–10 days has high risk of developing meningitis and likely to need surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Analysis and Clinical Importance of Skull Base Fractures in Adult Patients with Traumatic Brain Injury

Sivanandapanicker

Nagar

Kutty

et al. 2018

Journal of Neurosciences in Rural Practice

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“…reported similar findings in a recent study. [ 18 ] However, Emejulu et al . reported fractures of the anterior skull-base to be more common.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of clinical and computed tomography features of basal skull fractures in head injury in southwestern Nigeria

Olabinri

Ogbole

Adeleye

et al. 2015

Journal of Neurosciences in Rural Practice

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Background:Basal skull fractures (BSF) in head injury may be missed clinically. Early detection ensures prompt treatment and prevention of complications We compared the clinical and Computed Tomography (CT) features of basal skull fractures in head injured patients in a southwestern Nigerian hospital.Materials and Methods:Head injury patients who had cranial CT at a Southwestern Nigerian hospital were selected. CT images were acquired with a 64-slice Toshiba Aquillion CT scanner using a standard head protocol. The images were evaluated for evidence of skull fractures, and associated complications. The clinical data and CT findings were analyzed.Results:One hundred and thirty patients were evaluated, including 103 (79.2%) males. Their ages ranged between 7 months and 81 years, mean 35 years (SD, 20.3). In 59 patients (45.4%, 59/130) BSF was detected on CT, while 71 (54.6%) had no evidence BSF. Forty-two (71.2%) of the 59 patients detected on CT had clinical suspicion of BSF (P < 0.001) while the remaining 17 (28.8%) were not clinically diagnosed. This equaled a sensitivity of 71.2% and, specificity of 90.1% for clinical determination of BSF in this study. There was no statistically significant difference between clinical and CT diagnosis (P > 0.05). The commonest observed clinical feature in patients with confirmed BSF was otorrhagia (45.8%) and the petrous temporal bone (45.8%) was the most commonly fractured bone. The BSF was caused most commonly by motor bike accidents in 53 (40.8%). The most common associated intracranial injuries were intracerebral haemorrhage (34.6%) and subdural (17.3%)Conclusion:It appears that neurosurgical evaluation is comparatively reliable in evaluating basal skull fractures in this study area even as they are consistently demonstrated by high resolution CT scanners. A clinical suspicion of BSF should warrant a closer detailed CT evaluation and reporting by radiologists.

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“…Berbagai penelitian telah mengungkapkan bahwa cedera fosa kranial tengah paling banyak terlibat pada PTDK yang dikaitkan dengan tulang tipis di fossa kranial tengah yang terdiri dari beberapa foramina. 7,14,15,18 Namun, beberapa penelitian telah melaporkan fossa kranial anterior menjadi situs yang paling umum dari PTDK yang menjadi populasi penelitian ini. 4,13 Hal ini mungkin disebabkan karena dasar anatomi fossa kranial anterior yang mengandung tulang tipis dari tulang kribriform dan atap orbita.…”

Section: Bahasanunclassified

Hubungan Pola Patah Tulang dengan Gejala Klinis pada Patah Tulang Dasar Kepala (PTDK) Anterior

Musu,

Prasetyo,

Oley

et al. 2023

MSJ

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Traumatic brain injury can occur due to skull base fracture at the anterior, middle, and posterior parts with life-threatening complications. This study aimed to obtain the relationship between anterior skull base fracture pattern and its clinical signs and symptoms. This was a retrospective chart review with a cross-sectional design. Subjects were 50 patients with anterior skull base fracture based on 3D CT scan, and then their clinical signs and symptoms were evaluated. Data were analyzed bivariately using the Pearson Chi-Square test and the Fisher Exact alternative. The results showed that the most common clinical signs and symptoms in type I was anosmia; in type II, related to eyes; in type III, rhinorrhea; and in type IV, signs and symptoms of all entities. The most common fracture pattern in the subjects was frontolateral type (type III). There was a significant relationship between the pattern of fracture based on the 3D CT scan with the clinical signs and symptoms of patients including cerebrospinal fluid rhinorrhea, anosmia, racoon eyes, and visual deficit (p<0.001). In conclusion, there is a signifinat relationship between pattern of anterior skull base fracture with clinical signs and symptoms. Keywords: traumatic brain injury; anterior skull base fracture; 3D CT scan; clinical signs and symptoms Abstrak: Cedera otak akibat trauma (COT) dapat terjadi akibat patah tulang dasar kepala (PTDK) baik pada basis tengkorak anterior, tengah, dan posterior, dengan komplikasi mengancam jiwa. Penelitian ini bertujuan untuk mendapatkan hubungan pola patah tulang dengan gejala klinis pada PTDK anterior. Jenis penelitian ialah retrospektif menggunakan rekam medis dengan desain potong lintang. Subjek penelitian ialah 50 pasien PTDK anterior dengan pola patah tulang sesuai 3D CT scan dan dievaluasi kondisi klinisnya. Uji bivariat menggunakan uji Pearson chi-square dengan alternatif Fisher exact. Hasil penelitian mendapatkan gejala klinis yang paling umum: tipe I yaitu anosmia; tipe II yaitu gejala berhubungan dengan mata; tipe III yaitu rinorea; dan tipe IV memberikan gejala yang mencakup semua entitas. Pola patah tulang terbanyak ialah patah tulang frontolateral (tipe III). Pola patah tulang yang dinilai melalui 3D CT-scan berhubungan bermakna dengan derajat gejala klinis pasien PTDK anterior meliputi rinorea cairan serebrospinal, anosmia, racoon eyes, dan defisit visual (p<0,001). Simpulan penelitian ini ialah terdapat hubungan bermakna antara pola PTDK anterior dengan gejala klinis. Kata kunci: cedera otak akibat trauma; patah tulang dasar kepala anterior; 3D CT scan; gejala klinis

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Computerized tomography assessment of cranial and mid-facial fractures in patients following road traffic accident in South-West Nigeria

Cited by 12 publications

References 19 publications

Analysis and Clinical Importance of Skull Base Fractures in Adult Patients with Traumatic Brain Injury

Analysis and Clinical Importance of Skull Base Fractures in Adult Patients with Traumatic Brain Injury

Comparative analysis of clinical and computed tomography features of basal skull fractures in head injury in southwestern Nigeria

Hubungan Pola Patah Tulang dengan Gejala Klinis pada Patah Tulang Dasar Kepala (PTDK) Anterior

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