Incidence of Skull Fracture in Children Presenting with Brain Contusion

Objective: The objective of our study is to determine the incidence of skull fracture in children presenting with brain contusion.

Methods: The current prospective cross sectional study was conducted at Neurosurgery department of Lady Reading hospital Peshawar during July 2020 to Dec 2020. Total 100 children of age 6 months to 14 years were enrolled in this study by using non-probability consecutive sampling. Children of both gender and age 6 months to 14 years presenting with head injury associated with brain contusion were included in the study. Children with intracranial lesion other than hematoma, gunshot and penetrating injuries were excluded.

Results: Out of 100 children’s with brain contusion, 89% were diagnosed with skull fracture. The median age of the children with skull fracture was 72(18-108) months, and 70.7% of them were male. However no differences were observed in gender, age group, mechanism of trauma, site of contusion and size of contusion between fracture and non-fracture group. Moreover in children with skull fracture, linear skull fracture was most common followed by depressed skull fracture.

Conclusion:In our study prevalence of skull fracture among children presenting with traumatic brain injury is very high. Prompt diagnosis and management is necessary to prevent late neurologic complications in such patients. Clinicians should develop standard protocol for the assessment of children with brain contusion in emergency department in order to prevent misdiagnosis. This will help in reducing morbidity and mortality.