Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury
Purpose: A head injury (HI) may cause a skull fracture, which may or may not be associated with injury to the brain. In essence, a skull base fracture (SBF) is a linear fracture at the base of the skull. Loss of consciousness and Glasgow coma score (GCS) may vary depending on an associated intracran...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-10-01
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| Series: | Chinese Journal of Traumatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127519300719 |
| _version_ | 1818444532675510272 |
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| author | Ahmad Faried Danny Halim Ingrid Ayke Widjaya Rendy Febrian Badri Syailendra Fii Sulaiman Muhammad Z. Arifin |
| author_facet | Ahmad Faried Danny Halim Ingrid Ayke Widjaya Rendy Febrian Badri Syailendra Fii Sulaiman Muhammad Z. Arifin |
| author_sort | Ahmad Faried |
| collection | DOAJ |
| description | Purpose: A head injury (HI) may cause a skull fracture, which may or may not be associated with injury to the brain. In essence, a skull base fracture (SBF) is a linear fracture at the base of the skull. Loss of consciousness and Glasgow coma score (GCS) may vary depending on an associated intracranial pathology. The pathomechanism is believed to be caused by high energy impact directly to the mastoid and supraorbital bone or indirectly from the cranial vault. Aim of this study is to define the correlation between SBF and intracranial hemorrhage (ICH) in patients with HI. Methods: Analysis of data obtained from a retrospective review of medical records and from a systematized database pertaining to diagnostic criteria of SBF patients based only on clinical symptoms associated with ICH caused by HI treated in the Department of Neurosurgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia from January 1, 2012 to December 31, 2017. The exclusion criteria included age less than 15 years and no head computed tomography (CT) scan examination provided. Results: A total of 9006 patients were included into this study in which they were divided into 3 groups: group 1, HI with no ICH; group 2, HI with single ICH and group 3, HI with multiple ICH. In all the SBF cases, SBF at anterior fossa accounted for 69.40% of them, which were mostly accompanied with mild HI (64.70%). Severity of HI and site of SBF correlated with the existence of traumatic brain lesions on CT scan, thus these factors were able to predict whether there were traumatic brain lesions or not. Most of the patients with epidural hemorrhage (EDH) has single traumatic lesion on CT scan, whereas most of the patients with cerebral contusion (CC) has multiple traumatic lesions on CT scan. On patients with both traumatic brain injury and SBF, most of the patients with anterior fossa SBF has EDH; whereas most of the patients with middle fossa SBF were accompanied with CC. Surgery was not required for most of the patients with SBF. Conclusion: SBFs were strongly correlated with traumatic ICH lesions patients with anterior fossa SBF were more likely to suffer EDH whereas with middle fossa SBF were more likely to suffer CC. Keywords: Skull base fracture, Intracranial hemorrhage, Traumatic brain injury |
| first_indexed | 2024-12-14T19:17:26Z |
| format | Article |
| id | doaj.art-40768c0041b844769b72fde612c8e581 |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-12-14T19:17:26Z |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-40768c0041b844769b72fde612c8e5812022-12-21T22:50:31ZengElsevierChinese Journal of Traumatology1008-12752019-10-01225286289Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injuryAhmad Faried0Danny Halim1Ingrid Ayke Widjaya2Rendy Febrian Badri3Syailendra Fii Sulaiman4Muhammad Z. Arifin5Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, Indonesia; Bandung Injury Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Corresponding author. Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital (RSHS), Bandung, Indonesia.Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, IndonesiaPurpose: A head injury (HI) may cause a skull fracture, which may or may not be associated with injury to the brain. In essence, a skull base fracture (SBF) is a linear fracture at the base of the skull. Loss of consciousness and Glasgow coma score (GCS) may vary depending on an associated intracranial pathology. The pathomechanism is believed to be caused by high energy impact directly to the mastoid and supraorbital bone or indirectly from the cranial vault. Aim of this study is to define the correlation between SBF and intracranial hemorrhage (ICH) in patients with HI. Methods: Analysis of data obtained from a retrospective review of medical records and from a systematized database pertaining to diagnostic criteria of SBF patients based only on clinical symptoms associated with ICH caused by HI treated in the Department of Neurosurgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia from January 1, 2012 to December 31, 2017. The exclusion criteria included age less than 15 years and no head computed tomography (CT) scan examination provided. Results: A total of 9006 patients were included into this study in which they were divided into 3 groups: group 1, HI with no ICH; group 2, HI with single ICH and group 3, HI with multiple ICH. In all the SBF cases, SBF at anterior fossa accounted for 69.40% of them, which were mostly accompanied with mild HI (64.70%). Severity of HI and site of SBF correlated with the existence of traumatic brain lesions on CT scan, thus these factors were able to predict whether there were traumatic brain lesions or not. Most of the patients with epidural hemorrhage (EDH) has single traumatic lesion on CT scan, whereas most of the patients with cerebral contusion (CC) has multiple traumatic lesions on CT scan. On patients with both traumatic brain injury and SBF, most of the patients with anterior fossa SBF has EDH; whereas most of the patients with middle fossa SBF were accompanied with CC. Surgery was not required for most of the patients with SBF. Conclusion: SBFs were strongly correlated with traumatic ICH lesions patients with anterior fossa SBF were more likely to suffer EDH whereas with middle fossa SBF were more likely to suffer CC. Keywords: Skull base fracture, Intracranial hemorrhage, Traumatic brain injuryhttp://www.sciencedirect.com/science/article/pii/S1008127519300719 |
| spellingShingle | Ahmad Faried Danny Halim Ingrid Ayke Widjaya Rendy Febrian Badri Syailendra Fii Sulaiman Muhammad Z. Arifin Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury Chinese Journal of Traumatology |
| title | Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury |
| title_full | Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury |
| title_fullStr | Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury |
| title_full_unstemmed | Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury |
| title_short | Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury |
| title_sort | correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury |
| url | http://www.sciencedirect.com/science/article/pii/S1008127519300719 |
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