scholarly journals A Prospective Study of Spectrum of Depressed Fractures of Skull and its Surgical Outcome

2015 ◽  
Vol 6 (4) ◽  
pp. 134-138
Author(s):  
Vishwanath Sidram ◽  
PC Chandra Kumar ◽  
Bellara Raghavendra

ABSTRACT Background Depressed skull fracture is a very serious type of trauma occurring in 11% of severe head injuries, and there is a consistent association between the presence of cranial fracture and higher incidence of intracranial lesions, neurological deficit, and poor outcome. Depressed cranial fractures have to be treated aggressively because of their association with infection and late epilepsy. Objectives To study the clinical profile and surgical outcome of patients with depressed cranial fractures. Materials and methods A case series study of 44 patients with depressed fracture was conducted in a tertiary care hospital setting at the Department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, during the period from June 2013 to January 2015. Among the selected patients, the clinical profile, radiological profile, and surgical interventions were undertaken and the outcomes were noted. Appropriate descriptive statistics were used to analyze the findings and to draw inferences. Results There were 30 males and 14 females. The mean age of the patients was 26.95 ± 14.87 years (6–65 years). The common cause of depressed fracture was road traffic accident (45%) and assault (40.9%); 63% of them had compound type and half of the fractures were located in the frontal region. Common associated injuries were extradural hematoma (50%) followed by dural tear (27.3%). Common complications were wound infection (9.1%) and cerebrospinal fluid leak (9.1%). Conclusion The management of depressed fractures should be individualized depending on factors like the degree of depression, communication with the exterior, neurological deficit and presence of associated injuries. How to cite this article Sidram V, Kumar PCC, Raghavendra B. A Prospective Study of Spectrum of Depressed Fractures

2017 ◽  
Vol 08 (02) ◽  
pp. 204-208 ◽  
Author(s):  
Basavaraj Fakkirappa Banakar ◽  
Vandana Hiregoudar

ABSTRACT Background: Cortical venous thrombosis (CVT) is a rare condition, compared to arterial stroke and often occurs in young individuals presenting with varying clinical features. Aim: The aim is to study clinical profile and assess the outcome and prognostic factors of CVT patients. Methodology: A case series study was done for 2 years. CVT cases confirmed by magnetic resonance imaging were included in this study. Clinical presentation and risk factors were noted then patients were assessed at the time of discharge for their physical and mental status. Modified Rankin scale was used to group patients, accordingly scores 0–2 were considered as good and 3–6 as poor outcome, respectively. Data were analyzed using Chi-square test to know the association between prognostic factors and outcome. Results: Out of 81 patients, more than half of the patients were in the age group of <35 years (55.6%), and majority of patients were females (79%). Most common symptom was headache (82.7%) and least was fever (14.8%). Superior sagittal sinus was most commonly involved (74.1%). Nearly half of the patients were in puerperal period (44.1%). Patients aged more than 35 years (odds ratio [OR]: 9.1, confidence interval [CI]: 4.463–19.750) presenting with symptoms such as fever (OR: 3.442, CI: 1.088–12.140), impaired consciousness (OR: 5.467, CI: 2.064–15.330) and having clinical signs such as coma (OR: 23.99, CI, 3.844–544.1), papilledema (OR: 25.15, CI: 7.565–101.5), and with focal neurological deficit (OR: 9.366, CI: 2.693–3.41) had statistically significant poor outcome. Conclusion: Females formed a major bulk of patients. Higher number patients showed poor outcome. Study showed association between age, headache, impaired consciousness, coma, papilledema, and neurological deficit to poor outcome.


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