scholarly journals A Case of Depressed Skull Fracture of the Inner Table Alone

2021 ◽  
Vol 17 ◽  
Author(s):  
Ki Seong Eom
Keyword(s):  
Skull Fracture ◽  
Depressed Skull Fracture

scholarly journals Infected open depressed skull fracture complicated with tetanus grade I in an unimmunized child: a rare case report with literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Dzulfikar D. L. Hakim ◽  
Ahmad Faried ◽  
Adila Nurhadiya ◽  
Ericko H. Laymena ◽  
Muhammad Z. Arifin ◽  
...  
Keyword(s):  
Rare Case ◽  
Pediatric Population ◽  
Skull Fracture ◽  
Pediatric Intensive Care ◽  
Toxin Production ◽  
Clostridium Tetani ◽  
Anesthetic Care ◽  
Middle Income ◽  
Depressed Skull Fracture ◽  
Low Middle Income Countries

Abstract Background Tetanus is a rare disease caused by Clostridium tetani, which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low–middle-income countries, tetanus still occurs (mostly in adults) due to the lack of immunization related to religious tenets, cultural belief, or inaccessibility to medical care. In addition, tetanus in the pediatric population shows features which are quite distinct from the adult group. Case presentation We report a case of a 7-year-old girl presented to our institution with a history of falling 10 days prior to admission, with only skin laceration on her forehead. For 1 day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed her as an unimmunized child with an open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw.” Perioperative management of this rare case is reported and discussed. Conclusion The pediatric intensive care of such patients requires halting further toxin production, neutralization of circulating toxin, and control of the clinical manifestation induced by the toxin that has already gained access to the central nervous system. The basic tenets of anesthetic care in such case must be well-managed and planned prior to surgery.

Seemingly inconsequential yet catastrophic: the importance of wound washout with minute depressed skull fracture from a dog bite

2021 ◽  
Author(s):  
Josue D. Ordaz ◽  
Nichole H. Chicoine ◽  
John J. Manaloor ◽  
Salma M. Bakr ◽  
Jeffrey S. Raskin
Keyword(s):  
Skull Fracture ◽  
Dog Bite ◽  
Depressed Skull Fracture

Depressed skull fracture in a newborn baby

2009 ◽  
Vol 94 (2) ◽  
pp. F137-F137 ◽  
Author(s):  
S T Dharmaraj ◽  
N D Embleton ◽  
A Jenkins ◽  
G Jones
Keyword(s):  
Skull Fracture ◽  
Newborn Baby ◽  
Depressed Skull Fracture

Penetration of the Sagittal Sinus by a Depressed Skull Fracture

JAMA ◽  
1967 ◽  
Vol 202 (8) ◽  
pp. 841 ◽  
Author(s):  
Herbert F. Reilly
Keyword(s):  
Skull Fracture ◽  
Depressed Skull Fracture ◽  
Sagittal Sinus

Delayed Neurological Deterioration after Depressed Fracture over Superior Sagittal Sinus: Our Experience with 13 Patients

2020 ◽  
Vol 81 (04) ◽  
pp. 324-329
Author(s):  
Ahmed Elshanawany ◽  
Mahmoud Ragab
Keyword(s):  
Computed Tomography ◽  
Superior Sagittal Sinus ◽  
Skull Fracture ◽  
Csf Pressure ◽  
Visual Deterioration ◽  
Depressed Skull Fracture ◽  
Sagittal Sinus ◽  
Depressed Fracture ◽  
Neurologic Deterioration ◽  
Management Protocol

Abstract Objective To present our experience in the diagnosis and management protocol of 13 patients with a depressed skull fracture over the superior sagittal sinus (SSS) who developed delayed neurologic deterioration. Patients and Methods This retrospective study was conducted in the Neurosurgical Department, Assiut University Hospitals, between May 2012 and May 2017. All patients with a depressed skull fracture over the SSS were reviewed. Only those patients who were neurologically intact after trauma but suffered delayed neurologic deterioration were included in this study. Preoperative characteristics of age, sex, cause of trauma, type and site of the depressed skull fracture, and clinical presentation were reviewed and evaluated. Neuroimaging including brain computed tomography and computed tomography venography were evaluated. Results Of 612 patients with depressed skull fractures admitted to our department, 63 had the fracture segment on the SSS. Thirteen patients, nine males and four females, met the inclusion criteria (age range: 5–42 years). The most common cause of trauma was assault from others (seven patients). Eight patients had a compound depressed fracture; the other five fractures were simple. Interval between trauma and neurologic deterioration ranged between 4 days and 3 weeks. Clinical deterioration included decrease of consciousness, headache, blurred vision, and repeated vomiting. Deterioration of consciousness was seen in four patients. Eight patients had sixth cranial nerve palsy. Visual deterioration was seen in four patients. All the included patients were operated on for elevation of the depressed segment. Eleven patients improved; two patients who presented initially with visual deterioration did not improve. Their visual deterioration persisted after surgery. For both these patients, lumbar puncture revealed high cerebrospinal fluid (CSF) pressure. Clinical improvement followed the insertion of a thecoperitoneal shunt. Conclusion Increased intracranial pressure (ICP) may follow a depressed fracture over the SSS. It may occur immediately after trauma or later. Surgical decompression with elevation of the depressed segment is indicated. Persistence of manifestations of raised ICP despite elevation of the depressed segment indicates the occurrence of an SSS thrombosis. CSF pressure should be measured to confirm the diagnosis and consider a thecoperitoneal shunt.

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