جستجوی مقالات مرتبط با کلیدواژه "شکستگی جمجمه" در نشریات گروه "پزشکی"

Many advances have taken place in the management and treatment of head injured patients in recent years. Despite this, there have been few studies about depressed skull fractures as a subgroup of head injured patients. The aim of this study was to evaluate surgical results of patients with depressed skull fractures. This cross-sectional study was conducted on 74 patients (50 males and 24 females) with the mean age of 20 years (5- 52 years) who were admitted in neurosurgery department of Urmia Imam Khomeini hospital during 4 years (2009-2012) with depressed skull fracture and treated surgically. Preoperatively, CT scan was done in all patients. Prophylactic antibiotics and antiepileptics were administered in all cases. Variables such as: type and cause of fractures, neurologic deficit, seizure, postoperative meningitis, skin defect, wound infection, CSF leak and mortality were evaluated. Patients were followed up during one year after surgery. From 74 cases, 60(81%) were compound and 14(19%) cases were simple fractures. In 8(11%) patients fracture were crossed the midline (over superior sagittal sinus). The cause of depressed fractures were road traffic accident in 38(51%) cases, fall from height in 23(31%) cases, physical violence in 5(7%) cases, sports related injury in 2(3%) cases and miscellaneous in 6(8%) cases. Level of consciousness before surgery was ranged from 5 to 15 based on Glasgow Coma Scale. Postoperatively complete recovery occurred in 50(67.5%) cases, hemiparesis in 10(13.5%) cases, seizure in 4(5.4%) cases, dysphasia in 2(3%) cases, meningitis in 2(3%) cases, and skin defect with wound infection in 2(3%) cases. No death and CSF leak was recorded. Surgical treatment of depressed skull fracture with prophylactic antibiotics and antiepileptics has good results and few complications.

The purpose of evaluating children with mild head trauma is to identify patients with traumatic brain injury and to prevent brain from deterioration and secondary damage while limiting unnecessary imaging procedures. The present study aimed to investigate the frequency distribution of indications for computed tomography (CT) scan in children under 2 years of age with mild head trauma. In this cross-sectional study, medical files of 100 children under 2 years of age with mild trauma were investigated. Data such as age, sex, mechanism of head injury, level of consciousness before CT scan, repeated vomiting, decreased level of consciousness, craniofacial soft-tissue injuries, distant systemic damages, and the possible existence of brain lesions based on patient's CT findings was collected and evaluated. The mean age of patients, 63 of whom were male, was 18 ± 7.1 years. The most common cause of head injuries was falling from a height (66%). Based on CT scan findings, 55% of patients had abnormal CT findings. Age, sex, and mechanism of trauma were not significantly different between groups. Although repeated vomiting and decreased level of consciousness were more prevalent in patients with abnormal CT findings compared to those with normal results, the difference between the two groups was not significant. The results of the present study revealed that vomiting and decreased level of consciousness in children under 2 years of age with mild head injuries cannot be considered as the sole criteria to suspect brain injury and necessitate CT scanning.

Bilateral Intracranial hematoma is an uncommon sequela of closed head injury. Approach to this complicated problem is poorly defined. The present study tries to find out the incidence, and possible markers for the earlier detection of the problem. In this descriptive study all head trauma patients undergoing surgical decompression from September 2006 to October 2008 in Kashan Beheshti Hospital, were included. Cases were studied for age, sex, cause of trauma, skull fracture, Glasgow Coma Scale Score, pre-operative CT findings, and the number of surgical procedures. Using SPSS software, the obtained data was analyzed through descriptive statistics, Chi Square and t-test. During a 24-month period, for 96 admitted patients with traumatic injuries, 121 surgical procedures were performed. Due to the hematomas, 73 (75.3%) and 23 (24.7%) cases had one and more than one surgical operation, respectively. In addition, the age range was between 6 months and 83 years in the former and 17 and 66 years in the latter with a mean of 40.7±24.1 and 33.7±15.9, respectively. Male/female ratio was 13.7/1 in unilateral cases and 22/ 1 in bilateral cases. In 31 (43%) out of 73 unilateral hematomas and 12 (52%) out of 23 bilateral cases various types of skull fractures were seen. While no significant difference was seen between the groups in terms of age, sex, cause of trauma, skull fracture, and GCSS, it was significant for subdural hematoma (P=0.004). No specific marker could be found for early detection of bilateral intracranial hematoma. The high incidence of hematomas in our centre may be an incidental finding secondary to the high number of intracranial hematomas.