Zia-ur Rehman, Muhammad Mukhtar Khan, Shahid Ayub.
Clinicoradiological Features and Early Postoperative Outcome of Depressed Skull Fractures.
Pak J Neuro Surg Jan ;20(3):154-9.

Introduction: Skull fractures are frequently associated with head injury, especially in younger children and young adults. Upto 12% of head injury cases are associated with depressed fracture with a variety of clinical and radiological features. Clinical and radiological features of intracranial injuries are the chief determinants of postoperative functional outcome.Objectives: We aimed to study the diverse nature of clinical and radiological features and to determine their impact on the postoperative outcome in patients of depressed skull fractures.Materials and Methods: This is a prospectively conducted case series of a descriptive nature, conducted at the department of Neurosurgery, Hayatabad Medical Complex Peshawar between January 2015 and December 2015. All patients between age 15 years and 65 years, from both genders with the diagnosis of depressed skull fractures due to closed head injury were included. Patients with penetrating nature of trauma such as gunshot wounds or stab wounds were excluded.Results: 65 patients with 46 (70.9%) males and 19 (29.2%) females in a ratio of 2.42:1. The most common cause of injury was road traffic accident with a mean age of 25.14 years ± 6.23 SD. Compound fractures were present in 56.9% while the rest were simple. Mean arrival GCS was 11.0 ± 2.29 SD. Mean GCS at discharge was 12.8 ± 3.28 SD and mean GOS was 4.05 ± 1.13 SD. Favourable outcome was recorded in 75.4% of patients while the rest were in unfavourable group. Most common complications were septic which occurred in a total of 15.4% patients and was followed in frequency by CSF leaks postoperatively. There was no mortality.Conclusions: The clinical features such as arrival GCS, pupillary abnormalities, focal deficits and radiological features such as the presence of intracranial and parenchymal lesions predict the outcome in terms of Glasgow outcome score. Most commonly septic complications and CSF leaks occur as complications after surgery.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com