Management and outcome of posterior fossa extradural hematoma and management outcome

Presentation of patients with CT proven extra dural hematoma their management and out come. 12 patients of posterior fossa extradural hematoma were included in the study. Excellent recovery was found in 50% good in 25% and poor in 16.6% and 8.33% was died

Conservative and surgical management of depressed, skull fractures

The aim of the study is to examine the efficacy of a conservative and surgical management of depressed fractures skull. A prospective study of 120 patients with depressed skull fractures treated at Bolan Medical Complex Hospital from December 2003 -2007. There were 108 males and 12 females, age range was 12 month to 80 years, and the mean age was 40 years. All patients underwent X-ray and cranial CT scan. Depressed fractures due to missile injuries were excluded from the study. Object fall on the head was the cause of depressed fracture in 30% of our patients, fall from a height in 19%, road traffic accident in 20%, sports injury in 10%, assault in 19.8% and suicidal attempt in 1.2%. Parietal bone was injured in 44%, frontal bone in 32%, temporal bone in 18% and occipital bone in 6%. Seventy-two percent were compound depressed fractures and 28% were simple depressed fractures. Eighty-four patients were managed conservatively, 56 patients with compound fractures [66.7%] and 28 patients [33.3%] with simple fractures. Significant extra-axial haematoma was the indication for elevation of the fracture in 40% of the surgical group, significant wound contamination, brain tissue and CSF in the wound in 5%, frontal sinus involved in 15%, cosmetic deformity in 25%, fracture on the superior sagittal sinus in 10% and right sided hemiplegia in 5%. Our study demonstrates that 70% of patients with depressed skull fractures can be safely managed conservatively without major surgical intervention