No abstract available.
Skull Fracture, Depressed*

The authors describe a case of neonatal depressed skull fracture that was spontaneously elevated without surgical therapy. The depressed bone gradually became elevated, and at 3 months the depression had disappeared.
Depression ; Humans ; Infant, Newborn ; Skull Fracture, Depressed*

Surgical elevation of the depressed bone is known to be the conventional treatment usually recommended for a simple depressed skull fracture in the adult or pediatric age. The authors introduce, however, a case of depressed skull fracture in an infant which was elevated by means of a cup of breast pump and a suction generator without surgical elevation. In our case, without surgery, a 'cup-shaped' depressed skull fracture in an infant was safely elevated with no neurological signs. This method is considered a simple, effective, safe, and alternative procedure in an infant with simple depressed skull fracture.
Adult ; Breast* ; Humans ; Infant ; Skull Fracture, Depressed* ; Skull Fractures ; Suction*

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

OBJECTIVE: In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. METHODS: One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. RESULTS: Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was 50+/-45 months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. CONCLUSION: In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.
Adult ; Aged ; Child ; Emergencies ; Female ; Humans ; Male ; Skull ; Skull Fracture, Depressed ; Skull Fractures

In spite of the fact that there is general consensus that neonatal depressed skull fractures are caused largely by instrumental extraction, there are a few reports regarding congenital depression of the skull unrelated to external trauma. In the case herein, the mother did not have any history of abdominal trauma during pregnancy and the neonate was delivered vaginally without the use of instruments, yet a round depression was noted in the left parietal bone of the neonate at the time of delivery. Computed tomography with three dimensional reconstruction images was performed and a congenital depression of the neonatal skull without fracture was diagnosed. We describe this case with a brief review of the literature.
Consensus ; Depression ; Humans ; Infant, Newborn ; Mothers ; Parietal Bone ; Parturition ; Pregnancy ; Skull ; Skull Fracture, Depressed

Authors experienced one case of intrauterine depressed skull fracture which associated with skull capillary hemangioma. In reviewing literatures, there are two types of intrauterine skull depression, traumatic and spontaneous. Pressure of the fetal head against maternal bony structures accounts for most of the so-called spontaneous type. Authors case was spontaneous type and associated with "fetal factor", congenital capillary hemangioma of the skull.
Capillaries* ; Depression ; Head ; Hemangioma, Capillary* ; Humans ; Infant, Newborn* ; Skull Fracture, Depressed* ; Skull*

Authors experienced one case of intrauterine depressed skull fracture which associated with skull capillary hemangioma. In reviewing literatures, there are two types of intrauterine skull depression, traumatic and spontaneous. Pressure of the fetal head against maternal bony structures accounts for most of the so-called spontaneous type. Authors case was spontaneous type and associated with "fetal factor", congenital capillary hemangioma of the skull.
Capillaries* ; Depression ; Head ; Hemangioma, Capillary* ; Humans ; Infant, Newborn* ; Skull Fracture, Depressed* ; Skull*

The purpose of this report is to evaluate the validity of the differential diagnosis of epidural and subdural hematomas on the basis of the varied angiographic findings and also to determine the correlation between hematoma shape and the injury-angiogram time interval in subdural hematomas. Conventional cerebral angiograms in 27 cases of epidural and 53 cases of subdural hematoma among surgically proven 155 intracranial hematoma patients, observed at the Department of (Neurosurgery) Seoul National University Hospital, during the past 5 years from August, 1968 to July 1973, were reviewed. 53 subdural hematomas were subdivided into three groups upon the injury-angiogram time interval as follows: acute; within 48 hours ---------- 28 cases, subacute; 3 days to 2 weeks ---------- 14 cases, chronic; over 2 weeks ---------- 11 cases. The results were as follows: 1. In epidural hematoma, the A-P view of angiogram showed typical lentiform (biconvex) avascular zone in 11 cases and crescent-shaped avascular zone in 3 cases among total 27 cases, whereas in acute to subacute subdural hematoma it showed crescent-shaped avascular zone in 15 cases but only 2 cases showed the lentiform appearance. 2. Lentiform avascular zone was also typically seen in 5 cases of chronic subdural hematoma, but it might be differentiated from that of epidural hematoma with more clear inner margin in the former. 3. In epidural hematoma, the following characteristic findings providing excellent diagnostic aids were also noted. 1) medial or inward displacement of middle meningeal artery ---------- 3 cases, 2) extravasation from middle meningeal artery into arterio-venous sheath-4 cases into hematoma ---------- 2 cases, 3) amputation of middle meningeal artery ---------- 2 cases, 4) extravasation from dural sinus ---------- 4 cases, 5) displacement of dural sinus from the inner table of skull ---------- 4 cases, 6) lentiform avascular zone only ---------- 4 cases. In 20 cases of epidural hematoma, one or more of the above findings could be found. Among them, extravasation from middle meningeal artery and dural sinus, amputation of middle meningeal artery and displacement of dural sinus were thought as pathognomonic. In subdural hematoma, none of the above findings was seen. 4. In subdural hematoma, hematoma shape (avascular zone) showed some tendency to change its from according to the injury-angiogram time interval: in the group ranging from 1 to 7 days and over a month, the crescent-shaped hematoma was predominant and in the group between these periods, lentiform hematoma and hematoma with flat inner margin were somewhat predominant. But there was no valid basis for predicting the age of subdural hematoma from its configuration at angiography. 5. There was no direct correlation between the shape of the hematoma and the patients' age. 6. Simple skull roentgenogram provided some aids in the differential diagnosis between epidural and chronic subdural hematoma. 20 cases out of 27 epidural hematomas showed linear or depressed skull fracture, whereas only 1 out of 11 cases of chronic subdural hematoma showed linear skull fracture.
Amputation ; Angiography ; Diagnosis, Differential ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Chronic ; Humans ; Meningeal Arteries ; Seoul ; Skull ; Skull Fracture, Depressed ; Skull Fractures

A case of acute epidural hematoma associated with depressed skull fracture and cephalhematoma resolved spontaneously within three days, is reported. A female neonate was admitted for the evaluation of convulsion developed on the next day after delivery. Computed tomography(CT) revealed epidural hematoma and overlying cephalhematoma on the left parietal region. Repeated CT scan after three days showed total resolution of epidural hemotoma and slight enlargement of cephalhematoma. Redistribution of hematoma through communication between epidural hemotoma and cephalhematoma is suggested as the mechanism of spontaneous rapid resolution of epidural hemotoma.
Female ; Hematoma* ; Humans ; Infant, Newborn* ; Rabeprazole ; Seizures ; Skull Fracture, Depressed ; Tomography, X-Ray Computed