Traumatic intracranial hemorrhages in facial fracture patients: review of 2,195 patients

Abstract

Simple clinical symptoms, such as seizures, vomiting/nausea, history of a closed head injury or cranial vault fractures are strong predictors for intracranial hemorrhage in facial fracture patients. The early consideration of such important indicators allows us to detect patients at elevated risk of an intracranial hematoma requiring surgical intervention.

Post-traumatic morbidity is frequent in children with frontobasilar fractures

“…Similar findings were reported in a study of skull base fractures by Hohlriedel et al [16]. In their patients, intracranial bleeding was detected in 55%.…”

Presence of accompanying head injury in patients with maxillofacial trauma

“…While Kanno et al [18] did not detect an increase in the risk of intracranial hemorrhage in isolated and simple zygomatic, maxillary and mandibular fractures, they found a significant increase in the intracranial hemorrhage risk in isolated maxillary alveolar fractures and panfacial fractures. On the other hand, Hohlrieser et al [17] detected that the risk of head injury increased with maxillary fractures. On the contrary, Kloss et al [8] reported that the risk of head injury significantly increased in all facial fractures except maxillary fractures in their study carried out in patients with GCS score of 15.…”

“…[12][13][14][15][16][17] Nevertheless, the mean age of the patients exposed to maxillofacial trauma is above 30 years. [3,8,[14][15][16][17][18][19] There is a close relationship between the presence of accompanying head injury in patients with maxillofacial fractures. [2][3][4][5][6][7] The risk of experiencing head trauma varies between 2.04% and 14%.…”

“…While motor vehicle accident is the leading etiology in most of the studies in the literature, [1,6,13,14,16,[18][19][20][21] there are also studies available reporting that sports injuries [8,15] or assaults [2,3] are the most common etiologies in maxillofacial trauma. In many studies, while the risk of head trauma accompanying facial fractures has been reported to increase significantly, [8,16,18,22] Hohlrieder et al [17] reported that traffic accidents did not increase the risk of intracranial hemorrhage in 2195 patients with facial fractures. Kloss et al [8] found that assaults also increased the risk of intracranial hemorrhages accompanying maxillofacial trauma as well as traffic accidents.…”

Damage control of maxillofacial haemorrhage

“…5 Simple clinical symptoms, such as seizures, vomiting/nausea, history of a closed head injury or cranial vault fractures are strong predictors of facial haemorrhage in maxillofacial fracture patients. 2 Lifethreatening haemorrhage due to facial trauma is considered rare. In a 1025 case series of patients with facial fractures by Tung et al, 5 19 patients had a life-threatening haemorrhage (1.9%).…”