Assessment of the Relationship of Cranial and Facial Bone Fractures with Brain Consequences in Patients with Head Trauma Presenting to the Emergency Room of Pursina Educational & Medical Center From 2015 To 2017
Iranian Journal of Emergency Medicine,
Vol. 9 No. 1 (2022),
Introduction: Traumatic brain injury is one of the leading causes of death and disability. Traumatic brain injuries have multifactorial injury mechanisms and are often associated with other injuries. A large proportion of patients who suffer from traumatic brain injury also have facial injuries. Due to the anatomical proximity of the face and skull, patients with facial injuries are expected to be at higher risk for brain injuries. The present study was performed with the aim of investigating the relationship between facial and cranial fractures and brain consequence in head trauma patients.
Methods: This is an analytical cross-sectional study. The study population consisted of patients with skull and facial injuries due to head trauma. Fractures of the skull and face were classified into two categories: mandibular and middle part of the face. Brain consequence was considered as intracranial concussion and injury. Age, sex, mechanism of trauma, time and type of fracture, associated clinical symptoms, and level of consciousness of patients were recorded. Data were analyzed using STATA software.
Results: Out of 1625 patients with head injuries, 958 (60%) suffered facial and skull fractures. 700 people (71%) suffered brain injuries following a head injury, of which only 29% had no brain consequences. 50% of brain outcomes following facial and cranial bone fractures together, cranial bone fractures accounted for 29%, and facial fractures accounted for 21% of total brain outcomes. Most patients had brain concussions. Local pain was the most common symptom (75.2%). Overall, 36% of all facial fractures and 88% of skull fractures resulted in brain outcome.
Conclusion: There is a direct relationship between cranial and facial bone fractures and brain consequences in head trauma patients and concussion was the most common brain outcome in these patients. Urgent and timely measures are required in patients with skull and facial bone fractures to reduce the consequences and brain damage.
- Facial fractures
- Intracranial injuries
- Brain injuries
- facial injuries
- maxillofacial injuries
- intracranial hemorrhages
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Huckhagel T, Riedel C, Rohde V, Lefering R. Cranial nerve injuries in patients with moderate to severe head trauma–Analysis of 91,196 patients from the TraumaRegister DGU® between 2008 and 2017. Clinical neurology and neurosurgery. 2022;212:107089.
Elbaih AH, El-Sayed DA, Abou-Zeid AE, Elhadary GK. Patterns of brain injuries associated with maxillofacial fractures and its fate in emergency Egyptian polytrauma patients. Chinese journal of traumatology. 2018;21(05):287-92.
Huang L-K, Wang HH, Tu H-F, Fu C-Y. Simultaneous head and facial computed tomography scans for assessing facial fractures in patients with traumatic brain injury. Injury. 2017;48(7):1417-22.
You N, Choi MS, Roh TH, Jeong D, Kim S-H. Severe facial fracture is related to severe traumatic brain injury. World neurosurgery. 2018;111:e47-e52.
Rajandram RK, Syed Omar SN, Rashdi MFN, Abdul Jabar MN. Maxillofacial injuries and traumatic brain injury–a pilot study. Dental Traumatology. 2014;30(2):128-32.
Zandi M, Seyed Hoseini SR. The relationship between head injury and facial trauma: a case–control study. Oral and maxillofacial surgery. 2013;17(3):201-7.
Joshi UM, Ramdurg S, Saikar S, Patil S, Shah K. Brain injuries and facial fractures: A prospective study of incidence of head injury associated with maxillofacial trauma. Journal of maxillofacial and oral surgery. 2018;17(4):531-7.
Tse KM, Tan LB, Lee SJ, Lim SP, Lee HP. Investigation of the relationship between facial injuries and traumatic brain injuries using a realistic subject-specific finite element head model. Accident Analysis & Prevention. 2015;79:13-32.
Işik D, Gönüllü H, Karadaş S, KOÇAK ÖF, Keskin S, Garca MF, et al. Presence of accompanying head injury in patients with maxillofacial trauma. Ulus Travma Acil Cerrahi Derg. 2012;18(3):200-6.
Lucke-Wold B, Pierre K, Aghili-Mehrizi S, Murad GJA. Facial fractures: Independent prediction of neurosurgical intervention. Asian Journal of Neurosurgery. 2021;16(4):792.
Pham TT, Lester E, Grigorian A, Roditi RE, Nahmias JT. National analysis of risk factors for nasal fractures and associated injuries in trauma. Craniomaxillofacial Trauma & Reconstruction. 2019;12(3):221-7.
McCarty JC, Kiwanuka E, Gadkaree S, Siu JM, Caterson EJ. Traumatic brain injury in trauma patients with isolated facial fractures. Journal of Craniofacial Surgery. 2020;31(5):1182-5.
Salentijn EG, Peerdeman SM, Boffano P, van den Bergh B, Forouzanfar T. A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: incidence and aetiology. Journal of Cranio-Maxillofacial Surgery. 2014;42(6):705-10.
Lee H-J, Kim Y-J, Seo D-W, Sohn CH, Ryoo SM, Ahn S, et al. Incidence of intracranial injury in orbital wall fracture patients not classified as traumatic brain injury. Injury. 2018;49(5):963-8.
Abosadegh MM, Rahman SA, Saddki N. Association of traumatic head injuries and maxillofacial fractures: A retrospective study. Dental Traumatology. 2017;33(5):369-74.
Hilair CS, Johnson A, Loseth C, Alipour H, Faunce N, Kaminski S, et al. Facial fractures and associated injuries in high-versus low-energy trauma: all are not created equal. Maxillofacial Plastic Reconstructive Surgery. 2020;42(6):1-6.
Grant AL, Ranger A, Young GB, Yazdani A. Incidence of major and minor brain injuries in facial fractures. Journal of Craniofacial Surgery. 2012;23(5):1324-8.
Puljula J, Cygnel H, Mäkinen E, Tuomivaara V, Karttunen V, Karttunen A, et al. Mild traumatic brain injury diagnosis frequently remains unrecorded in subjects with craniofacial fractures. Injury. 2012;43(12):2100-4.
Thorén H, Snäll J, Salo J, Suominen-Taipale L, Kormi E, Lindqvist C, et al. Occurrence and types of associated injuries in patients with fractures of the facial bones. Journal of oral and maxillofacial surgery. 2010;68(4):805-10.
Asif S, Farooq SMY, Fatima M, Saleem M, Leezam SA, Jallad LKF. FREQUENCY OF INTRACRANIAL HEMATOMAS RELATED TO TRAUMATIC SKULL OR FACIAL INJURIES EVALUATED ON COMPUTED TOMOGRAPHY. Pakistan BioMedical Journal. 2022;5(1).
Patil SG, Munnangi A, Joshi U, Thakur N, Allurkar S, Patil BS. Associated injuries in maxillofacial trauma: a study in a tertiary hospital in south India. Journal of maxillofacial and oral surgery. 2018;17(4):410-6.
Aldwsari OM, Aldosari KH, Alzahrani MK, Alzahrani ZA, Alanazi AH, Alkhathlan KM, et al. Associated head injuries and survival rate of patients with maxillofacial fractures in road traffic accident: A prospective study in Saudi Arabia. Journal of family medicine and primary care. 2018;7(6):1548.
Al-Hassani A, Ahmad K, El-Menyar A, Abutaka A, Mekkodathil A, Peralta R, et al. Prevalence and patterns of maxillofacial trauma: a retrospective descriptive study. European journal of trauma and emergency surgery. 2019:1-7.
Faried A, Halim D, Widjaya IA, Badri RF, Sulaiman SF, Arifin MZ. Correlation between the skull base fracture and the incidence of intracranial hemorrhage in patients with traumatic brain injury. Chinese Journal of Traumatology. 2019;22(5):286-9.
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