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Contrecoup injury in patients with traumatic temporal bone fracture

  • Z A Asha'Ari (a1), R Ahmad (a1), J Rahman (a2), N Kamarudin (a3) and L Wan Ishlah (a1)...

Abstract

Objective:

To study the prevalence and patterns of contrecoup injury in traumatic temporal bone fracture cases.

Method:

A prospective, cohort study was undertaken of all patients with traumatic head injury admitted to a tertiary referral hospital in Malaysia within an 18-month period. High resolution computed tomography scans of the brain and skull base were performed in indicated cases, based on clinical findings and Glasgow coma score. Patients with a one-sided temporal bone fracture were selected and subsequent magnetic resonance imaging performed in all cases. Contrecoup injury incidence, type, severity and outcome were recorded.

Results:

Of 1579 head injury cases, 81 (5.1 per cent) met the inclusion criteria and were enrolled in the study. Temporal bone fractures were significantly associated with intracranial injuries (p < 0.001). The incidence of a contrecoup injury in cases with temporal bone fracture was 13.6 per cent. Contrecoup injury was significantly associated with petrous temporal bone fracture (p < 0.01). The commonest contrecoup injury was cerebral contusion, followed by extradural haematoma and subdural haematoma.

Conclusion:

Contrecoup injury is not uncommon in cases of temporal bone fracture, and is significantly associated with petrous temporal bone fracture.

Copyright

Corresponding author

Address for correspondence: Dr Zamzil Amin Asha'Ari, Assistant Professor, Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, International Islamic University Malaysia, Jalan Hospital, 25100 Kuantan, Pahang, Malaysia Fax: 609 5133615 E-mail: zamzilamin@yahoo.com

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