A study of clinical presentation and management of base of skull fractures in our tertiary care centre

Abstract

Basal skull fractures remain one of the more difficult head and neck fractures to evaluate and treat. They often have extensive associated injuries, both intracranial and extra-cranial, which make the management of the patients more challenging.The aim of this study was to analyze the clinical presentations, management and outcome of patients with base of skull fractures. This study was conducted in 174 cases with evidence of base of skull fractures on CT scans, which satisfied the inclusion and exclusion criteria. All patients were clinically evaluated and treatment as defined by the senior consultants in the department of neurosurgery. At the end of the study, clinical presentation, management and outcome of these patients were evaluated.Base of skull fracture is common in head injuries, seen in 53% of cases in this study group and most common in the 3rd decade of life. Most common mode of injury was road traffic accidents in adults and fall in children. Raccoon eye sign was seen only in 26.1% of cases. Temporal bone was the most common bone involved. Acute hemorrhagic contusion was the most commonly associated intracranial finding followed by acute Subdural hematoma. Acute subdural hemorrhage was the most common indication for surgery. Fifty eight percentage of patient recovered with a GCS of 13 or more. The mortality rate in this study group was 10.34%. However, the cause of death was the associated severe intracranial injury.

Keywords

• Base of skull fracture
• Head trauma
• Cranial nerve injury
• CSF leak