Correlation of Fracture Depression Level and Dural Tear in Patients With Depressed Skull Fracture

Shokouhi, Ghaffar; Sattarnezhad, Neda; Motlagh, P Samad; Mahdkhah, Ata

doi:10.1097/wnq.0b013e31828c7410

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…The current study reported a significant correlation between high levels of fracture, depression, and dural tear amongTBI patients (12). This evidence demonstrates that dural tear could be a diagnostic factor in patients operated for a depressed skull fracture.…”

Section: Discussionsupporting

confidence: 68%

“…The mean levels of area, based on CT findings, (12) The numbers show the frequency of patients with these signs. were obtained as 6.92 cm² in patients with intact dura, and 7.2 cm² in patients with dural tear.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, it has been taken into consideration by operating surgeons that the dural tear should properly be closed either primarily or with the help of dural substitutes. This measure may prevent the risk of serious morbidity and mortality among patients with TBI (6)(7)(8)(9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

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Correlation of fracture depression area and dural tear among patients with depressed skull fracture

et al. 2020

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Introduction: Depressed skull fracture means to have a fracture that has a depth of more than a bone thickness. Consequently, the force is very small to a blunt object, which is often seen in the frontoparietal region due to the low bone thickness in the area. On the other hand, tearing of the dura matter beneath the depressed fractures has a great value from the prognostic and surgical point of view. This study aimed to investigate the relationship between the area of the depressed fracture and dural tear using computerized tomography scan at admission. Methods: This cross-sectional study was performed on 40 patients who had been diagnosed with depressed skull fractures atImam Reza Educational Center, Tabriz University of Medical Sciences, Tabriz, Iran,within2016-2017. The level of consciousness, the Glasgow Coma Scale, and symptoms on admission were evaluated for each patient. The collected data were analyzed in SPSS software (version 22) using studentchr('39')s t-test and Chi-square test for statistical analysis of parametric and nonparametric variables. A p-value of less than 0.05 was considered significant. Results: The mean age of the cases was obtained as 34/9±14/32 (18-60) years. The mean depressed fracture area (6/93±5/52) ranged from 0/79-19/63cm² (7.13±5.99) for the patients with dural tear and 6.93±5.66 for the ones with intact dura. The cut-off point for predicting dural tear was determined 6.92 cm² with 84% sensitivity. Conclusions: It was revealed that there was a significant correlation between the area of fracture depression and dural tear. Furthermore, in patients with dural tear, fracture depression level was considerably higher than that in patients with intact dura.

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Section: Discussionsupporting

confidence: 68%

Section: Resultsmentioning

confidence: 99%

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Correlation of fracture depression area and dural tear among patients with depressed skull fracture

et al. 2020

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“…In closed fractures, surgical management was rarely offered by the majority of respondents. Although there is no available class I evidence for the level of bony depression as an indicator for surgery, evidence suggests that the greater the depression, the higher the likelihood of dural tears, 18 which, in turn, can be indicative of underlying cortical damage. Higher rates of posttraumatic epilepsy have been reported in cases of depressed fractures with dural tears, 19 but this likely reflects cortical damage, and elevation does not appear to negate this risk.…”

Section: Surgical Indicationsmentioning

confidence: 99%

Variations in the Neurosurgical Management of Depressed Skull Fractures in Adults: An International Cross-Sectional Survey

Suliman

Jayakumar

Chaurasia³

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims Depressed skull fractures have been well-described since antiquity, yet its management remains controversial. Contentious issues include the use of prophylactic antibiotics and antiepileptics, the role of non-operative management, and the replacement/removal of bone fragments. Our objective was to explore the management patterns of closed and open depressed skull fractures across the world. Material and Methods A 23-item, web-based survey was distributed electronically to the members of national neurosurgical associations, and on social media platforms. The survey was open for data collection from December 2020-April 2021. Statistical calculations were performed with SPSS v22 (IBM). Results A total of 218 respondents completed the survey, representing 56 countries. With regards to open fractures, most respondents (85.8%) treated less than 50 cases annually. Most respondents (79.4%) offered prophylactic antibiotics to all patients with open fractures, with significant geographical variation (p<0.001). Less than half (48.2%) offered prophylactic antiepileptics. Almost all (>90%) reported the following indications as important for surgical management: (1) grossly contaminated wound; (2) dural penetration; (3) depth of depression; and (4) underlying contusion/haematoma with mass effect. Most respondents treated less than 50 cases of closed depressed skull fractures annually. Most European respondents (81.7%) did not offer prophylactic antiepileptics in comparison to most Asian respondents (52.7%) (p<0.001). Depth of depression, an underlying haematoma/contusion with mass effect, and dural penetration were the most important surgical indications. Conclusions There remains a great degree of uncertainty in the management strategies employed across the world in treating depressed fractures, and future work should involve multi-national randomised trials.

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Predicting Dural Tear in Compound Depressed Skull Fractures: A Prospective Multicenter Correlational Study

et al. 2018

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Correlation of Fracture Depression Level and Dural Tear in Patients With Depressed Skull Fracture

Cited by 5 publications

References 16 publications

Correlation of fracture depression area and dural tear among patients with depressed skull fracture

Correlation of fracture depression area and dural tear among patients with depressed skull fracture

Variations in the Neurosurgical Management of Depressed Skull Fractures in Adults: An International Cross-Sectional Survey

Predicting Dural Tear in Compound Depressed Skull Fractures: A Prospective Multicenter Correlational Study

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