Post-traumatic morbidity is frequent in children with frontobasilar fractures

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• 作者：Ulla Perheentupa^a ; ^{ulla.perheentupa@utu.fi} ; ^{ulperh@utu.fi} ; Ilpo Kinnunen^a ; Reidar Gré ; nman^a ; Kalle Aitasalo^a ; Jari O. Karhu^b ; Antti A. Mä ; kitie^c
• 关键词：Frontobasilar trauma ; Frontobasilar fracture ; Pediatric trauma ; Traumatic brain injury
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2012
• 期刊代码：135_01655876
• 类别：med
• 出版时间：May, 2012
• 卷：76
• 期：5
• 页码：670-674
• 文件大小：503 K

摘要

Objective

Frontobasilar fractures are potentially life-threatening injuries also in pediatric populations, often due to associated intracranial trauma. This retrospective study was performed at a tertiary care university hospital to evaluate the management and outcome of pediatric frontobasilar fractures. The secondary aim was to re-evaluate the computerized tomography images to reveal all the skull base fracture sites predicting morbidity.

Methods

A retrospective analysis of all the 20 consecutive pediatric patients diagnosed with and treated for a frontobasilar fracture at the Turku University Hospital, Turku, Finland during 1995-2010 was performed. The referral area of this tertiary care university hospital covers 750,000 inhabitants of whom approximately 20%are 18 years or younger.

Results

The mean annual incidence of frontobasilar fractures was 1.1 per 100,000 children aged 18 years and under. A road traffic accident was the most common etiological factor. Other factors included being hit by a heavy object, falling from a height, and falling to the ground. The mean Glasgow Coma Scale score was 10 and loss of consciousness was initially detected in 15 (75%) patients in the emergency unit. Twelve (60%) patients had an intracranial injury, 17 (85%) had facial bone fractures, and 15 (75%) had a fracture of the anterior cranial base. The middle cranial fossa and sella were affected in five (25%) of the patients. There seem to be no long-term neuroendocrine sequelae following brain injury, not even when the sella or the hypophyseal area was affected. Twelve (60%) patients were treated operatively. One patient died after one week of intensive care treatment. Only four (20%) patients had no post-traumatic implications, eight (40%) suffered from various long-term sequelae, and five (25%) had permanent neurological or neuropsychological sequelae.

Conclusions

Frontobasilar fractures in childhood are rare and often associated with intracranial trauma and long-term morbidity. However, according to this study, 75%of the patients showed no permanent neurological or neuropsychological sequelae.