Frequency of Intracranial Hemorrhage among Patients with Skull Fractures in Blunt Head Trauma

Abstract

Background: The global incidence of fatal head injuries is greater than the number of non-fatal cases. The presence or absence of a skull fracture, its type and site along with the type of intracranial hemorrhage has immense significance in the final outcome in cases of head injuries.
 Objective: To determine the frequency of intracranial hemorrhage and its different pattern in patients presented with skull fracture following blunt head injury in a tertiary care setting.
 Material and Methods: The study employed cross sectional study design and was conducted in Neurosurgery Unit of Lady Reading Hospital, Peshawar. The study duration was six months after approval of synopsis (29-06-2019 to 29-12-2019). A sample size of 196 patients was calculated using WHO calculator. Non probability consecutive sampling was used for patient’s selection. Ethical approval and consent forms were taken. Diagnosis of skull fracture and intracranial bleeding were made on the basis of CT brain and per op findings. Data was analyzed using SPSS version 17. Post stratification chi-square test was applied. P value ≤0.05 was considered significant.
 Results: Total 196 patients were included in study. There were 129(65.8%) male and 67(34.2%) female. Mean age of patients was 35.7 years±9.9SD. Intracranial hemorrhage was present in 32(16.3%). Type of intracranial hemorrhage was subdural in 10(5.1%), intrcerebral 3(1.5%), subarchnoid 3(1.5%), intraventricular 4(2%), contusion 2(1%), combination 2(1%), and extradural 8(4.1%). Intracranial hemorrhage is significantly associated with GCS, Occupation, cause of injury, location of injury and type of intracranial injury (p<0.001).
 Recommendation: According to the findings, frequency of intracranial hemorrhage was relatively high. This study recommend all patients with skull fractures due blunt head trauma be subjected to thorough brain damage check-up. The type and location of skull fracture is an indirect indicator of the severity of force of impact which leads to damage to the underlying brain and results in fatality.