Turkish Neurosurgery 1999 , Vol 9 , Num 3-4
EVALUATION OF CLINICAL RESULTS IN 40 PATIENTS WITH BASAL SKULL FRACTURE
Memduh KERMAN, Ahmet DAĞTEKİN, Varol AYDIN, N. Nefi KARA, Hacı KAYMAZ
Süleyman Demirel University Faculty of Medicine, Department of Neurosurgery, Isparta, Turkey Fractures of the basis cranii are usually the result of extension of a vault fracture. The most important complications associated with these fractures are cerebrospinal fluid (CSF) fistula, related infection, and pneumocephalus with fistula. CSF fistula involves the leakage of fluid from the subarachnoid space to the extraarachnoidal space through a defect in the arachnoidea, the dura, or the epithelial tissue. Although this leakage can occur along the cerebrospinal axis, it most often appears clinically as otorrhea and rhinorrhea. Eighty percent of CSF fistulae is caused by trauma, and this complication is seen in 2-5% of closed head trauma cases. With regard to outcome, 85% of rhinorrhea cases and 95% of otorrhea cases improve spontaneously within a week. Meningitis is the most important complication of CSF fistulae. We retrospectively studied 40 basis cranii fracture cases that were treated at our clinic between November 1994 and December 1997. Thirty-four of the patients were male (85%) and six were female (15%), and their ages ranged from 2 to 70 years. The most common cause of the fractures was traffic accident. The patients' Glasgow Coma Scale (GCS) scores ranged from 3 to 15. Of the 40 individuals studied, 19 had otorrhea and 5 had rhinorrhea. Tension pneumocephalus occurred in two cases during the time they were receiving treatment. Posttraumatic meningitis developed in three of our patients, and the mortality rate associated with meningitis was 5% (2/40 patients). Our study also highlighted the importance of other complications that may accompany basis fracture, namely, posttraumatic intracranial infection and tension pneumocephalus. Keywords : Basal skull fracture, CSF fistula, meningitis, tension pneumocephalus
Corresponding author : Memduh Kerman