11. DEPRESSED SKULL FRACTURE: SURGICAL MANAGEMENT AND OUTCOME

Sohail Amir

1Department of Neurosurgery, Naseer Teaching Hospital, Peshawar - Pakistan

Abstract

Objective: To study the characteristics, associated intracranial injury, indication of surgery and outcome in patients
with depressed skull fracture.
Material and Methods: This descriptive (cross sectional) study was conducted at Neurosurgery Department of Naseer
Teaching Hospital, Peshawar, Pakistan from January 2014 to December 2015. 83 patients underwent surgical procedure
were studied. Clinical data regarding age, sex, occupation, mode and time of injury, loss of consciousness, seizures,
vomiting, ENT bleed, site of fracture and type of fracture were documented. Post-operative complications were noted.
Outcome was measured by Glasgow coma scale. All the patients were followed at 5th postoperative day.
Result: A total of 83 patients were taken into account, comprising of 69 male and 14 female with male to female ratio
of 6:1. The age ranged from 1 to 60 years. 40(48%) patients were in age group of 0 to 15 years followed by 19(23%)
in 16 -30 years age range, 17(21%) in 31-45 years and 7(8%) were in age group of 46-60 years. The most common
region was the parietal 25 (30%), followed by temporal 16(19%). Frontal region was effected in 11(14%) and occipital
in 10(12%) subjects. 7 patient developed wound infection, 2 patients developed meningitis, 1 patient with chronic
infection of scalp developed osteomyelitis of skull. Neurological deficit was seen in 3 while pseudomeningocele in 1
patient. 69(83%) had a very good outcome.
Conclusion: DFS is a very common neurosurgical emergency. Surgery is a good option and should be done whenever
indicated as the results are favorable in most of cases.

Keywords: depressed skull fracture, surgical intervention, outcome

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