Growing skull fracture is a rare complication of a closed head injury during infancy and childhood. Most growing skull fracture are located in the parietal region. The authors report a case of growing skull fracture of the orbital roof using three dimentional computerized tomography(3-D CT) imaging, the shpae and the size of defect were clearly demonstrated.
Head Injuries, Closed ; Orbit* ; Rabeprazole ; Skull Fractures* ; Skull*

OBJECTIVES: To investigate the correlation of the initial Computerized Tomography(CT) findings of the brain and the functional outcome, and to suggest the initial CT findings as a functional outcome predictor in the traumatic brain injured(TBI) patients. METHODS: Thirty-nine TBI patients were included in this study. Subjects were divided into groups of non-focal or focal TBI, and with or without a depressed skull fracture according to their initial brain CT findings. RESULTS: The non-focal TBI patients were not significantly different from focal TBI patients in the days from onset to rehabilitation, rehabilitation stay, and initial FIM score. However their outcome in FIM gain and FIM efficiency significantly worse than focal TBI patients. The TBI patients with a depressed skull fracture were not significantly different from the patients without a depressed skull fracture in the days from onset to rehabilitation, rehabilitation stay, and intial FIM score. However their outcomes were significantly worse than patients without a depressed skull fractrue in FIM efficiency. CONCLUSION: The initial brain CT findings were generally useful for the prediction of functional outcomes in TBI patients.
Brain Injuries ; Brain* ; Humans ; Rehabilitation ; Skull ; Skull Fracture, Depressed

OBJECTIVETo investigate the surgical therapy of midline skull defect accompanied with frontal sinus injury.

METHODS11 cases with midline skull defect accompanied with frontal sinus injury were treated. Free temporal fascia was transplanted to close the top of frontal sinus after curettage of the frontal sinus wall. Then titanium prostheses were used to repair the skull defects at the same stage in 10 patients. 1 patient received skull defect repair at the second stage operation.

RESULTSGood results were achieved in 10 cases. The titanium prosthesis had to be taken out in one case due to frontal sinusitis and the anastomosis of frontal sinus and nasal cavity was performed.

CONCLUSIONSIn patients with midline skull defect accompanied with frontal sinus injury, free temporal fascia could be used to close the top of frontal sinus after curettage of frontal sinus wall. If there is no infection or mild infection in frontal sinus, the skull defect repair could be performed in the same stage. If there is severe frontal sinusitis, the defect repair should be done at the second stage.

Facial Injuries ; surgery ; Frontal Sinus ; injuries ; Humans ; Prosthesis Implantation ; methods ; Skull ; injuries ; Skull Fractures ; surgery ; Titanium

Frontal Sinus ; injuries ; Humans ; Skull Fractures ; therapy

It is known that free-falling accident is one of the major causes of head or spinal injury, especially in the elderly and children. But, the frequent injury types are diverse according to the reports because of the different subjects studied among the reports. A cranio-spinal injury caused by free-falling accident from height hasn't been studied a lot in Korea yet. To evaluate the clinical aspects of cranio-spinal fracture caused by free-falling injury which developed particularly in a certain fixed place, we analyzed 122 patients who had had the fractures involving extremities, ribs, and cranio-spinal regions during the past 4 years from January 1994 through July 1997. Forty-seven patient(38.5%) had the cranio-spinal fracture. The incidence of the skull and vertebral body fracture were significantly higher than that of the vertebral transverse process fracture, respectively (p=.052 and p=.007). There was statistically insignificant in the height of falls between the skull and vertebral body fracture(p=.175). Associated extra- craniospinal fractures were noted on radius(25.4%), rib(20.5%), femur(9%), calcaneus(5.7%), and pelvic bone(4.9%), in order of frequency.
Aged ; Child ; Extremities ; Head ; Humans ; Incidence ; Korea ; Ribs ; Skull ; Skull Fractures ; Spinal Injuries

The prognosis of severe head injured patients (Glasgow coma scale 3 to 8) was assessed through clinical prognostic factors in 209 cases, retrospectively. Severe head injured patients were 9.1% of all head trauma and 55% of cases were diffuse brain injury. Mechanism of injury were motorvehicle accident, falls, bicycle, and others. The patients with normal pupillary reaction had a significantly higher percentage of good outcome (77%) than the patient with bilateral 3rd nerve palsy (14.2%)(p<0.0001), 79% of good motor responsive patients had a good outcome compared to none of patients with poor motor response(p<0.0001). The patients with short duration of unawareness(within 30days) significantly higher percentage of good outcome(98%) than the patients with long duration of unawaereness(24%)(p<0.0001). The patients with initial high GCS score(6-8 score) had a significantly higher good outcome(58%) than the patients with low GCS score(3-5 score)(p<0.0001), 87% of pediatric patients had a good outcome compared to 38% of adults(p<0.0001). The diffuse head injured patients without basal cistern compression had a significantly hgher percentage of good outcome(83%) than the patients with basal cistern compression(41%)(p<0.0001), 62% of patients with skull fracture had a good outcome compared to 39% of patients without skull fracture(39%)(p<0.0017). Individual prognostic factors affect to patient's outcome and utilize to be powerful tool for assessing the relative efficacy of alternative treatments as well as patient's prognosis.
Brain Injuries ; Coma ; Craniocerebral Trauma ; Head* ; Humans ; Paralysis ; Prognosis ; Retrospective Studies ; Skull ; Skull Fractures

Pneumocephalus is defined as the presence of air or gas within the cranial cavity. It is usually associated with disruption of the continuity of the skull after head and facial trauma, neuro or otorhinolaryngologic surgery, and rarely, spontaneously. But a case of pneumo-hydrocephlus, a special subtype of pneumocephalus, has been rarely reported. This is a case of a 26-year-old quadriplegic patient who traumatic brain injury with left frontoparietal skull bone fracture and epidural hemorrhage with developed of pneumo-hydrocepahlus in the ventricle 6 months after injury. The mechanism of this case can be explained by the "inverted bottle" hypothesis. Clinical observation suggests that the leakage of cerebrospinal fluid through the ventricle-peritoneal shunt tube caused negative pressure gradient differences resulting in the inflow of outside air into the ventricle through fissures created by concealed fracture of the skull base.
Adult ; Brain Injuries ; Fractures, Bone ; Head ; Hemorrhage ; Humans ; Pneumocephalus ; Skull ; Skull Base ; Ventriculoperitoneal Shunt

This study was performed to evaluate bone formation in the calvaria of rabbit by the concept of guided bone regeneration with titanium mesh membrane and demineralized freeze-dried bone. The animal was sacrificed at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. 1. The titanium mesh but the biocompatibility was excellent the cell-occlusiveness was feeble. 2. The cell-occlusiveness was feeble and also the soft tissue growth of the upper part of the newly-formed bone after operating was excellent in early stage. 3. The maintenance ability of the space for the GBR very was excellent. 4. The titanium mesh the tissue-integration was superior the wound fixation ability excellent. 5. The demineralized freeze-dried bone did not promote the bone regeneration. 6. With the lapse of time, formation quantity of the bone some it increased, it increased quantity very it was feeble. Within the above results, the titanium mesh for the guided bone regeneration was excellent, the demineralized freeze-dried bone confirmed does not promote bone regeneration.
Animals ; Bone Regeneration ; Maintenance ; Membranes ; Osteogenesis* ; Skull ; Titanium* ; Wounds and Injuries

Ethmoid Bone ; injuries ; Humans ; Orbital Fractures ; surgery ; Skull Fractures ; surgery

A case of traumatic internal carotid artery injury associated with skull base fracture, Le Fort II fracture and mandible fracture after maxillofacial blunt trauma which resulted in delayed blindness is presented. This condition would appear to be a rare consquence of maxillofacial trauma. Internal carotid artery injury including dissection is an important consequence of blunt craniomaxillofacial trauma with potentially devastating consquences. It should be emphasized that skull base fracture involving the course of the internal carotid artery provides an important clue to significant vascular injury and, when present, provides the impetus for vascular imaging study.
Blindness* ; Carotid Artery, Internal* ; Mandible ; Skull Base ; Vascular System Injuries