Compound elevated skull fractures

Review of literature

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Introduction: Compound elevated skull fractures (CESF) are rare traumatic injuries. To date, only 27 cases have been reported. Methods: The authors report three cases of CESF managed at their institute. All were middle-aged males. The mechanism was assault by sharp-edged objects in two and road traffic accident (RTA) in one case. One underwent simple suturing; debridement and decompressive craniectomy was done in the remaining two cases. Good and poor outcomes were noted in one case each, while one died. A literature review was performed to analyse all cases of CESF reported in English literature. Results: Including this one, a total of 30 cases were analysed. Mean age was 25.2 years, of which seven were aged < 18 years. There were 12 mild, five moderate, 11 severe HI cases and two cases were not detailed. Underlying injuries were seen in ~ 2/3 of cases. All, except two cases, underwent definitive surgery in the form of debridement with/without haematoma removal. Good-to-excellent outcomes were noted in 2/3 cases. There were 6/30 (20%) deaths noted. CNS infections and poor admission GCS were associated with increased mortality rates. Conclusions: CESF are rare injuries. Early surgery in the form of debridement with broad-spectrum antibiotic coverage is recommended to prevent infectious complications and improve outcome. Outcome is dependent on three main factors—admission GCS score, intactness of duramater and post-operative CNS infections.

Original languageEnglish
Pages (from-to)434-439
Number of pages6
JournalBrain Injury
Volume31
Issue number4
DOIs
Publication statusPublished - 21-03-2017

Fingerprint

Skull Fractures
Debridement
Wounds and Injuries
Decompressive Craniectomy
Literature
Traffic Accidents
Infection
Hematoma
Anti-Bacterial Agents
Mortality
Skull
Central Nervous System
Surgery

All Science Journal Classification (ASJC) codes

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Prasad, G. Lakshmi ; Anmol, N. / Compound elevated skull fractures : Review of literature. In: Brain Injury. 2017 ; Vol. 31, No. 4. pp. 434-439.
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abstract = "Introduction: Compound elevated skull fractures (CESF) are rare traumatic injuries. To date, only 27 cases have been reported. Methods: The authors report three cases of CESF managed at their institute. All were middle-aged males. The mechanism was assault by sharp-edged objects in two and road traffic accident (RTA) in one case. One underwent simple suturing; debridement and decompressive craniectomy was done in the remaining two cases. Good and poor outcomes were noted in one case each, while one died. A literature review was performed to analyse all cases of CESF reported in English literature. Results: Including this one, a total of 30 cases were analysed. Mean age was 25.2 years, of which seven were aged < 18 years. There were 12 mild, five moderate, 11 severe HI cases and two cases were not detailed. Underlying injuries were seen in ~ 2/3 of cases. All, except two cases, underwent definitive surgery in the form of debridement with/without haematoma removal. Good-to-excellent outcomes were noted in 2/3 cases. There were 6/30 (20{\%}) deaths noted. CNS infections and poor admission GCS were associated with increased mortality rates. Conclusions: CESF are rare injuries. Early surgery in the form of debridement with broad-spectrum antibiotic coverage is recommended to prevent infectious complications and improve outcome. Outcome is dependent on three main factors—admission GCS score, intactness of duramater and post-operative CNS infections.",
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Compound elevated skull fractures : Review of literature. / Prasad, G. Lakshmi; Anmol, N.

In: Brain Injury, Vol. 31, No. 4, 21.03.2017, p. 434-439.

Research output: Contribution to journalReview article

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AU - Prasad, G. Lakshmi

AU - Anmol, N.

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AB - Introduction: Compound elevated skull fractures (CESF) are rare traumatic injuries. To date, only 27 cases have been reported. Methods: The authors report three cases of CESF managed at their institute. All were middle-aged males. The mechanism was assault by sharp-edged objects in two and road traffic accident (RTA) in one case. One underwent simple suturing; debridement and decompressive craniectomy was done in the remaining two cases. Good and poor outcomes were noted in one case each, while one died. A literature review was performed to analyse all cases of CESF reported in English literature. Results: Including this one, a total of 30 cases were analysed. Mean age was 25.2 years, of which seven were aged < 18 years. There were 12 mild, five moderate, 11 severe HI cases and two cases were not detailed. Underlying injuries were seen in ~ 2/3 of cases. All, except two cases, underwent definitive surgery in the form of debridement with/without haematoma removal. Good-to-excellent outcomes were noted in 2/3 cases. There were 6/30 (20%) deaths noted. CNS infections and poor admission GCS were associated with increased mortality rates. Conclusions: CESF are rare injuries. Early surgery in the form of debridement with broad-spectrum antibiotic coverage is recommended to prevent infectious complications and improve outcome. Outcome is dependent on three main factors—admission GCS score, intactness of duramater and post-operative CNS infections.

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