J Korean Soc Emerg Med.  2016 Dec;27(6):514-521. 10.0000/jksem.2016.27.6.514.

The Relationship of the Facial Injury Location and the Traumatic Brain Hemorrhage

• Park SH
• Han SB
• Suh YJ
• Kang S
• Kim AD
• Lee HM
• Kim AJ

• KMID: 2369038
• DOI: http://doi.org/10.0000/jksem.2016.27.6.514

Abstract

PURPOSE
Several studies have reported that facial fractures were associated with traumatic brain injuries or cervical injuries. The purpose of this study was to analyze the relationship between the location of facial injury and traumatic brain hemorrhage in order to support future decisions for image evaluation in facial injury patients.
METHODS
In this retrospective cohort study, we evaluated facial injury patients without external head trauma who visited the emergency department at our hospital between January 1, 2014 and October 31, 2014. We divided the cohort into 2 groups: Facial injury patients with associated traumatic brain hemorrhage and those without traumatic brain hemorrhage. We compared the factors related to traumatic brain hemorrhage, such as facial injury locations, mechanism of accident, types of wounds, altered mentality, headache, and loss of consciousness between the two groups.
RESULTS
In 873 patients, 73 (8.36%) presented traumatic brain hemorrhage and the other 800 had no traumatic brain hemorrhage on a brain computed tomography (CT) scan. The rate of headache, loss of consciousness, altered mentality, traffic accident, fall down, fracture, temporal injury, frontal injury, multiple facial area injury, and upper facial area (frontal and upper orbital area) injury were higher in the traumatic brain hemorrhage group than in the non-traumatic brain hemorrhage group (p<0.05). The risk factors of traumatic brain hemorrhage were headache, loss of consciousness, altered mentality, facial bone fracture, and temporal area injury of the face.
CONCLUSION
If a facial injury patient has any of the following factors temporal area injury, facial bone fracture, altered mentality, headache, and loss of consciousness, we have to evaluate the brain CT scan even if the patient had no external head injury.

Keyword

Fracture; Trauma; Temporal bone; Traumatic brain injury

MeSH Terms

Accidents, Traffic
Brain
Brain Hemorrhage, Traumatic*
Brain Injuries
Cohort Studies
Craniocerebral Trauma
Emergency Service, Hospital
Facial Bones
Facial Injuries*
Fractures, Bone
Headache
Humans
Intracranial Hemorrhages
Multiple Trauma
Orbit
Retrospective Studies
Risk Factors
Temporal Bone
Tomography, X-Ray Computed
Unconsciousness
Wounds and Injuries