Epilepsy after nonmissile depressed skull fracture

1974 ◽  
Vol 41 (2) ◽  
pp. 208-216 ◽  
Author(s):  
Bryan Jennett ◽  
J. Douglas Miller ◽  
Reinder Braakman
Keyword(s):  
Clinical Data ◽  
Skull Fracture ◽  
Skull Fractures ◽  
Content Type ◽  
Depressed Skull Fracture ◽  
Posttraumatic Amnesia ◽  
Fine Print

✓ Of 1000 patients with nonmissile depressed skull fractures, 10% had early epilepsy (first week) and 15% developed late epilepsy. The risk of late epilepsy varied widely but could be predicted from clinical data 1 week after injury. In more than one-third of the patients with depressed fractures the risk of late epilepsy is less than 4%, but in some patients it is over 60%. The risk is increased if posttraumatic amnesia exceeds 24 hours, if the dura is torn, if there are focal signs, or if there has been early epilepsy.

Depressed skull fracture in the neonate

1979 ◽  
Vol 50 (4) ◽  
pp. 512-514 ◽  
Author(s):  
Brian S. Saunders ◽  
Stephen Lazoritz ◽  
Robert D. McArtor ◽  
Paul Marshall ◽  
William M. Bason
Keyword(s):  
Direct Observation ◽  
Skull Fracture ◽  
Skull Fractures ◽  
Content Type ◽  
Depressed Skull Fracture ◽  
Neurological Signs ◽  
Vacuum Extractor ◽  
Breast Pump ◽  
Fine Print

✓ The authors describe three cases of neonatal depressed skull fracture that were elevated by means of an obstetrical vacuum extractor. In one case, a transparent breast pump shield replaced the metal vacuum extractor cup, permitting direct observation as the depression was elevated. Neonatal depressed skull fractures not associated with neurological signs may be safely elevated without surgery using the obstetrical vacuum extractor.

Management of depressed skull fracture in the newborn

1976 ◽  
Vol 44 (1) ◽  
pp. 62-64 ◽  
Author(s):  
John D. Loeser ◽  
H. Lee Kilburn ◽  
Tim Jolley
Keyword(s):  
Surgical Therapy ◽  
Epileptiform Activity ◽  
Skull Fracture ◽  
Neurological Deficits ◽  
Skull Fractures ◽  
Content Type ◽  
Depressed Skull Fracture ◽  
Neurological Signs ◽  
The Absolute ◽  
Fine Print

✓ The authors describe three cases of neonatal depressed skull fracture subsequent to difficult delivery, treated without surgical elevation. None of the patients developed neurological deficits, cosmetic deformity or electroencephalographic signs of epileptiform activity. Neonatal depressed skull fractures not associated with focal neurological signs may not require surgical therapy; we are not certain what the absolute criteria for operation should be.

Spontaneous elevation of a depressed skull fracture in an infant

1975 ◽  
Vol 42 (6) ◽  
pp. 726-727 ◽  
Author(s):  
Gerald Ross
Keyword(s):  
Skull Fracture ◽  
Content Type ◽  
Depressed Skull Fracture ◽  
Fine Print

✓ This is a report of an infant with a depressed skull fracture that apparently elevated spontaneously within a period of 4 hours.

Epidermoid and dermoid cysts

1977 ◽  
Vol 47 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Beniamino Guidetti ◽  
Franco M. Gagliardi
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Postoperative Complications ◽  
Clinical Data ◽  
Late Results ◽  
Content Type ◽  
Operating Technique ◽  
The Central Nervous System ◽  
Fine Print

✓ The authors report on the clinical data, operating technique, postoperative complications, and late results in a series of 31 epidermoid and 21 dermoid cysts of the central nervous system.

Cranioplasty with inner table of bone flap

1985 ◽  
Vol 62 (4) ◽  
pp. 607-609 ◽  
Author(s):  
Kazuhiko Kyoshima ◽  
Hirohiko Gibo ◽  
Shigeaki Kobayashi ◽  
Kenichiro Sugita
Keyword(s):  
Foreign Body Reaction ◽  
Skull Fracture ◽  
Bone Defects ◽  
Skin Incision ◽  
The Body ◽  
Bone Flap ◽  
Growing Skull Fracture ◽  
Content Type ◽  
Additional Exposure ◽  
Fine Print

✓ A new method of cranioplasty is described in which the inner table of the bone flap obtained during craniotomy is used for grafting. The method was used in 10 cases to repair bone defects caused by a growing skull fracture in two, created during removal of an invasive skull tumor in two, during the approach to intraorbital tumors in two, and secondary to craniectomy for additional exposure in four. The method has the advantage that a piece of the inner table for grafting can be obtained from the craniotomy bone flap, without the need for an additional skin incision or taking a graft from another part of the body, and foreign-body reaction is minimal.

The management of “asymptomatic” epidural hematomas

1989 ◽  
Vol 70 (3) ◽  
pp. 392-396 ◽  
Author(s):  
Neville W. Knuckey ◽  
Steven Gelbard ◽  
Mel H. Epstein
Keyword(s):  
Risk Factors ◽  
Epidural Hematoma ◽  
Skull Fracture ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Management Protocol ◽  
Major Vessel ◽  
Low Incidence ◽  
A Prospective Study ◽  
Fine Print

✓ Standard neurosurgical management mandates prompt evacuation of all epidural hematomas to obtain a low incidence of mortality and morbidity. This dogma has recently been challenged. A number of authors have suggested that in selected cases small and moderate epidural hematomas may be managed conservatively with a normal outcome and without risk to the patient. The goal of this study was to define the clinical parameters that may aide in the management of patients with small epidural hematomas who were clinically asymptomatic at initial presentation because there was no clinical evidence of raised intracranial pressure or focal compression. A prospective study was conducted of 22 patients (17 males and five females) aged from 1 to 71 years, who had a small epidural hematoma diagnosed within 24 hours of trauma and were managed expectantly. Of these, 32% subsequently required evacuation of the epidural hematoma 1 to 10 days after the initial trauma. Analysis of the patients revealed that age, sex, Glasgow Coma Scale score, and initial size of the hematoma are not risk factors for deterioration. However, deterioration was seen in 55% of patients with a skull fracture transversing a meningeal artery, vein, or major sinus, and in 43% of those undergoing computerized tomography (CT) within 6 hours of trauma. In contrast, only 13% of patients in whom the diagnosis of a small epidural hematoma was delayed over 6 hours subsequently required evacuation of the epidural collection. Of patients with both risk factors, 71% required evacuation of the epidural hematoma. None of the patients suffered neurological sequelae attributable to this management protocol. It was concluded that patients with a small epidural hematoma, a fracture overlaying a major vessel or major sinus, and/or who are diagnosed less than 6 hours after trauma are at risk of subsequent deterioration and may require evacuation. Conversely, patients without these risk factors may be managed conservatively with repeat CT and careful neurological observation, because of the low risk of delayed deterioration.

Rapid resolution of acute epidural hematoma

1988 ◽  
Vol 68 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Nobuhiko Aoki
Keyword(s):  
Epidural Hematoma ◽  
Clinical Course ◽  
Skull Fracture ◽  
Fracture Line ◽  
Concomitant Increase ◽  
Content Type ◽  
Rapid Resolution ◽  
Acute Epidural Hematoma ◽  
Fine Print

✓ Two cases of acute epidural hematoma with rapid resolution followed by a benign clinical course are reported. Because of the concomitant increase in the epicranial hematoma over a linear skull fracture in each case, the acute epidural hematoma was presumed to have been decompressed into the epicranial region through the fracture line.

Air in acute epidural hematomas

1986 ◽  
Vol 65 (4) ◽  
pp. 555-556 ◽  
Author(s):  
Nobuhiko Aoki
Keyword(s):  
Temporal Bone ◽  
Clinical Significance ◽  
Epidural Hematoma ◽  
Pediatric Patients ◽  
Skull Fracture ◽  
Air Bubbles ◽  
Content Type ◽  
Air Bubble ◽  
Acute Epidural Hematoma ◽  
Fine Print

✓ Two pediatric patients with acute epidural hematomas containing air bubble(s) are reported. A skull fracture was observed extending to the mastoid cells of the temporal bone in both patients. In one patient the hematoma and air bubbles subsequently increased in volume, requiring a craniotomy. The clinical significance of air in an acute epidural hematoma is discussed.

Computerized tomography of cranial sutures

1984 ◽  
Vol 61 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Yoshimi Furuya ◽  
Michael S. B. Edwards ◽  
Charles E. Alpers ◽  
Brian M. Tress ◽  
Douglas K. Ousterhout ◽  
...  
Keyword(s):  
High Resolution ◽  
Computerized Tomography ◽  
Developmental Changes ◽  
Cranial Sutures ◽  
Skull Fractures ◽  
Anatomical Structures ◽  
Content Type ◽  
Print Knowledge ◽  
Tomography Scanning ◽  
Fine Print

✓ Knowledge of normal suture anatomy and development is vital in order to understand abnormal suture development and to be able to distinguish sutures radiographically from normal anatomical structures and possible skull fractures. The anatomy of the sutures and synchrondroses of 150 normal pediatric and adult patients was studied using high-resolution computerized tomography scanning. Sutures of both the calvaria and skull base were most accurately identified in axial and coronal high-resolution thin-section scans when bone window algorithms were used. Developmental changes of the sutures and synchodroses, the inner and outer tables, and the diploic space were all well delineated. Vault sutures could be identified routinely in children, but their presence in adults varied considerably. With increasing age, parasutural sclerosis developed and sutures were more closely apposed.

Contrecoup skull fractures

1975 ◽  
Vol 42 (5) ◽  
pp. 530-534 ◽  
Author(s):  
Charles S. Hirsch ◽  
Benjamin Kaufman
Keyword(s):  
Head Injuries ◽  
Skull Fractures ◽  
Pathological Features ◽  
Content Type ◽  
Fine Print

✓ The authors describe the frequency, pathological features, and significance of contrecoup fractures of the anterior cranial fossae, which occur commonly when falls with occipital or temporal impacts cause fatal head injuries.

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