Anticipation of Dural Tear in Patients with Blunt Head Trauma

Abstract

Background: Dural tears are considered among the neurosurgical challenges to be dealt with during management of head trauma patients; it’s important to anticipate such pathology pre-operatively; the purpose of this study is to discuss and analyze various predictors of dural tear as a sequala of blunt head trauma. Methods: Patients with blunt head trauma who underwent surgery during the year 2020 were analyzed; operative data were reviewed; only patients with reported dural repair as a step during surgery were included. Patients with penetrating head injury were excluded. Preoperative radiology, epidemiological and clinical details were analyzed to conclude specific criteria for dural tear. Results: Twenty-three patients were involved in the study; male predominance was evident. The most common primary injury was depressed fracture (73.9%), while the most common mode of trauma was domestic injury (43.5%), especially in pediatric group (76.9%). Two cases of growing skull fracture were involved, and both were in pediatric group. CT findings were conclusive for immediate dural tear findings, however, suggestive for patients with growing skull fractures. Mean depth of depression for depressed fracture group was 15.07 mm. Conclusion: Dural tears are not a serious complication of head trauma, however, their sequalae are life-threatening. Anticipation of dural tear is feasible radiologically pre-operatively for immediate dural repair and craniotomy fashioning; for cases of growing skull fractures, it’s difficult to anticipate the course from time of impact till time of presentation.