SKULL FRACTURES IN HEAD-INJURED PATIENTS ATTENDING THE ACCIDENT AND EMERGENCY DEPARTMENT OF THE TEACHING HOSPITAL AT KADHIMIYA: A RETROSPECTIVE STUDY OF 100 CONSECUTIVE CASES

F. Naser, Reem; WH Al-Rawi, Walid

	SKULL FRACTURES IN HEAD-INJURED PATIENTS ATTENDING THE ACCIDENT AND EMERGENCY DEPARTMENT OF THE TEACHING HOSPITAL AT KADHIMIYA: A RETROSPECTIVE STUDY OF 100 CONSECUTIVE CASES
IRAQI JOURNAL OF MEDICAL SCIENCES
Article 1, Volume 5, Issue 1, 2007, Pages 82-94
Authors
Reem F. Naser; Walid WH Al-Rawi
Abstract
Background: A skull fracture (SF) finding in acutely head injured patient represents a neurosurgical emergency that necessitates admission to the hospital as it indicates a significant head trauma and can be accompanied by life threatening complications. Objective: To study the pattern of SF in 100 head injured patients presented to the Accident and Emergency (A and E) Department at Al-Kadhimiya Teaching Hospital. Methods: 100 patients having fresh SF were examined during October 2001 to February 2003 inclusive. All patients had plain skull X-ray, CT scanning; MRI study. Results: The most common causes were fall from height (FFH) (40%), road traffic accidents (RTA) (37%), assaults (13%), collapse of building (4%), diving (1%), missile (1%) and miscellaneous causes (4%). While eighty-six patients had single SF, 14 patients harbored multiple SF, all totaling 118 SF. The pattern of SF was fissure fracture (66.1%), depressed (20.3%), fracture base of skull (8.5%) and diastatic (5.1%). At Glasgow Coma Scale (GCS) scoring, 69% had a score of 13-15, 22% a score of 9-12, and 9% had a score of 3-8. Intracranial haematomas were extradural 14, subdural 3, and 1 intracerebral haematoma. Conclusions: The majority of SFs are simple fissure patterns affect mainly young age groups who sustain HI; males are more involved than females. Conventional X- ray, spiral CT scan and MRI are essential for determination of the type of SF. Since the majority of accidents have occurred in urban sites, 80%, the authors think that HI may be a phenomenon of urbanization. Moreover, the majority of the causes of SF(s), the authors think, are preventable, like FFH and RTA, by adequate measures such as family supervision, community education, safe house construction and traffic regulation legislation. Although the majority of cases had high GCS scores indicating a mild severity of trauma, however, a proper management and skilled care would contribute to avoidance of life-threatening complications and effect recovery. Key words: head injury, skull fracture, neuro-imaging, CT scan, MRI venography, family and school supervision
Keywords
head injury; skull fracture; Neuro; Imaging; CT scan; MRI venography; family and school supervision

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