Presentation
The first case involved a 22-year-old patient who presented with depressed skull fracture overlying the posterior third of the SSS. Symptoms of BIH developed within 48 h. [ncbi.nlm.nih.gov]
Entire Body System
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Dog Bite
The necessity of searching for skull fractures in children following dog bites in this region is emphasized. [ncbi.nlm.nih.gov]
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Localized Edema
However, local edema subsides usually after few days once active phase of injury is over [ 9 ]. Conclusion We conclude that, at times mild head injury can manifest as depressed skull fracture. [panafrican-med-journal.com]
Gastrointestinal
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Dyspepsia
FOCAL NEUROLOGICAL DEFICITS 1) Dyspepsia [impairment of speech, consisting of lack of coordination and failure to arrange words in their proper order due to a central lesion of the brain. 2) Visual field defects [e.g. dark spots or scotomas in the visual [sacramentoinjuryattorneysblog.com]
Neurologic
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Altered Mental Status
All had significant head trauma with altered mental status and a Glasgow Coma Score of 3-12. [ncbi.nlm.nih.gov]
All had significant head trauma with altered mental status and a Glasgow Coma Score of 3–12. [karger.com]
mental status, or concern for NAT Consult Neurosurgery and hopitalize. [ Addioui, 2016 ] Sometimes, unfortunately, the skull fracture is not due to Gravity, but rather something more sinister. [pedemmorsels.com]
Therefore, basic guidelines as to when to seek medical care can include the following: Altered mental status. The child is not acting or behaving normally for that child. [emedicinehealth.com]
mental status, clinical evidence of basilar skull fracture). [emedicine.medscape.com]
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Dysphasia
The patient was well at follow up three months later, with a mild expressive dysphasia which had resolved at a 12 month follow up. [emj.bmj.com]
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Neurologic Manifestation
Further, as in our case, initially there were no associated neurological manifestations of injury, so depressed fractures may be missed if radiological investigations are not done. [panafrican-med-journal.com]
Workup
Hence, all of the potential complications listed are associated with a graver prognosis if the primary fracture is missed during the diagnostic workup. [emedicine.medscape.com]
X-Ray
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Periostal Elevation
Elevation of the depression was therefore made through a small incision along the rear edge of the frontal bone using a periosteal elevator. [ncbi.nlm.nih.gov]
EEG
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Epileptiform Activity
None of the patients developed neurological deficits, cosmetic deformity or electroencephalographic signs of epileptiform activity. [ncbi.nlm.nih.gov]
Microbiology
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Staphylococcus Aureus
Staphylococcus aureus was isolated following culture of the pus. The patient improved clinically, and postoperative CT showed resolution of the abscess. He was discharged after completion of a 21 day course of intravenous antibiotics. [emj.bmj.com]
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Clostridium Perfringens
Two cases of Clostridium perfringens infection occurring less than 24 hours after compound depressed skull fracture are reported. [ncbi.nlm.nih.gov]
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Pseudomonas
Epidermidis, and Pseudomonas) - Anticonvulsants : The 2016 Brain Trauma Foundation guidelines recommend phenytoin to decrease incidence of early post-traumatic seizures. There is insufficient evidence to recommend levetiracetam over phenytoin. [emdaily.cooperhealth.org]
Treatment
The use of surgical treatment for depressed skull fractures that are located over major venous sinuses is a matter of controversy. [ncbi.nlm.nih.gov]
Prognosis
There were both cosmetic and neurological concerns and we found no clear consensus on appropriate treatment and prognosis in the literature we had available. 2015 BMJ Publishing Group Ltd. [ncbi.nlm.nih.gov]
Treatment and prognosis There are a number of indications for operative management, this include 2-4 : dural breach, increased risk if 5mm depression from inner table depression 5-10 mm significant intracranial hemorrhage frontal sinus involvement significant [radiopaedia.org]
[…] intracerebral bleeds may be present Differential Diagnosis Sutures are symmetrical and have well-corticated margins Treatment Depressed skull fractures usually require elevation of the depressed fragment when it is depressed deeper than the adjacent inner table Prognosis [learningradiology.com]
The type of basilar fracture will help decide the patient’s prognosis and treatment plan. Depressed Skull Fractures When a high-energy blunt force strikes a small surface of the skull, it can result in a depressed skull fracture. [kitaylaw.com]
Epidemiology
Epidemiology of head injury. J Neurol Neurosurg Psychiatry 1996 ; 60 : 362 –9. Ommaya AK, Genarrelli TA. Cerebral concussion and traumatic unconsciousness: correlation of experimental and clinical observations on blunt head injuries. [emj.bmj.com]
Epidemiology of head injury. J Neurol Neurosurg Psychiatry. 1996; 60:362?9. This article on PubMed Golfinos, JG, Cooper, PR. Skull fracture and post-traumatic cerebrospinal fluid fistula. In: Head Injury - 4th edition. [panafrican-med-journal.com]
Fractures in Children: Epidemiology and Activity – Specific Fracture Rates. J Bone Joint Surg Am, 2013 Apr 03;95(7). CONTINUE SCROLLING FOR RELATED SLIDESHOW [medicinenet.com]
Pathophysiology
Pathophysiology of iatrogenic and traumatic skull base injury. Adv Otorhinolaryngol. 2013;74:12-23. doi: 10.1159/000342264. Epub 2012 Dec 18. Review. PubMed PMID: 23257548. [lifeinthefastlane.com]
Serious cases usually result in death Pathophysiology [ edit ] A basilar skull fracture as seen on CT Diagram showing bones that may be involved in a basilar skull fracture Basilar skull fractures include breaks in the posterior skull base or anterior [en.wikipedia.org]
Pathophysiology of head injury Most head injuries result from blunt trauma, as distinct from a penetrating wound of the skull and brain caused by missiles or sharp objects. [surgwiki.com]
Prevention
This clinical and experimental examination should aid in preventing head injuries in skiing accidents because head injuries are mostly the result of depressed fractures, accompanied by brain contusions or hematomas. [ncbi.nlm.nih.gov]
Some of these complications can be prevented by good management, which must be based on awareness of the implications of this type of injury. [sacramentoinjuryattorneysblog.com]