Clinical Feature of Intracranial Lesion in Head Injury Patients with Skull Fracture

Lee, Young Bae; Park, Yong Seok; Lee, Kyu Chun; Jung, Ju Ho

Abstract

OBJECTIVE
A development of intracranial lesions in patients with head trauma is one of the most important prognostic factor. The brain CT scanning plays a vital role in early diagnosis of traumatic intracranial lesions. But all patients with head trauma are not evaluated with brain CT scaninning, and skull x-ray have a valuable role as a screening procedure in patients with head trauma. The presence of a skull fracture has been thought to correlate with occult intracranial lesions that may result in delayed neurological deterioration. We have undertaken a retrospective study to evaluate the development of intracranial lesions and the significance of skull fracture in patients with head trauma.
METHODS
A analysis of 80 cases with skull fractures who were admitted to our department from January 2002 to December 2004 was made according to their clinical informations, skull x-ray films, initial and repeated brain CT scans and prognosis.
RESULTS
In the results, a linear skull fracture was the most common type in 54 cases(67.5%), and the most common site of fracture was temporo-parietal skull in 20 cases(25%). Intracranial lesions were identified in 52 cases(65%) on initial brain CT scan and types of intracranial lesions were epidural hematoma in 23 cases(28.8%), hemorrhagic cerebral contusion in 22 cases(27.5%), subdural hematoma in 14 cases(17.5%) and intracerebral hematoma in 10 cases(12.5%). Repeated brain CT scanning was performed in 68 cases and delayed lesions were identified in 26 cases(38.2%).
CONCLUSIONS
The presence of skull fracture is a important and valuable indicator for development of intracranial lesions and skull x-ray film is a good screening evaluation method in patients with head trauma.