Compound elevated skull fracture: a forgotten type of skull fracture

Surgical Neurology
Augustine Abiodun AdeoluYemisi Bola Amusa

Abstract

We report 4 patients who presented with a rare type of vault fracture. This form of fracture has only been described in few instances in the literature. All the patients presented with elevation of free skull fracture fragments. The etiologies were assault (1 patient), domestic accident (1 patient), and road traffic accident (2 patients). All the fractures were compound as in previously reported cases. Delay in surgery resulted in cerebral abscess in 1 patient. Surgery was performed in all the patients: wound debrident, duroplasty, and reduction of fracture in 3 patients and craniotomy with excision of abscess in 1 patient. Two of the patients did well after surgery. The patients with abscess died 9 days after surgery. Another patient developed CSF fistula after surgery, and died of aspiration while waiting for the closure of the fistula. Elevated skull fractures in our series were all compound fractures. Both long, sharp objects as well as blunt objects can cause this injury. Delay in surgery could result in intracranial sepsis. We suggest that this fracture should be included in the classification of skull fractures.

References

Aug 1, 1976·Journal of Neurosurgery·J Verdura, R J White

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Citations

Mar 25, 2016·The Indian Journal of Surgery·Rakesh GuptaAbhishek Songara
Mar 17, 2010·Neurology India·S Bhaskar
Dec 14, 2011·World Neurosurgery·Srikant BalasubramaniamHemant V Savant
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Feb 24, 2017·The Journal of Craniofacial Surgery·Ken R WinstonYasuaki Harasaki
Jul 24, 2020·International Journal of Legal Medicine·Anne-Catherine Kessler, Roland Hausmann
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Mar 8, 2017·Brain Injury : [BI]·G Lakshmi Prasad, N Anmol

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