TITLE:
Anticipation of Dural Tear in Patients with Blunt Head Trauma
AUTHORS:
Mohamed M. Elsherbini, Ali H. Elmokadem, Hatem Badr, Amr F. Khalil
KEYWORDS:
Dural Tear, Growing Skull Fracture, Head Trauma, Depressed Fracture
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.3,
June
16,
2022
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.