The occurrence of traumatic cavotid carernous fistla after fracture of basilaris cranii and its associated factors with outcome / 中华急诊医学杂志

ABSTRACT

Objective To analyze the occurrence of traumatic carotid cavemons fistula (TCCF) resulted from the fracture of basilaris cranii, in order to find out the related factors to outcomes and to discuss the approaches to improving prognosis.Method Data of 312 patients with the fracture of skull base complicatcd with TCCF con-firmed angiography from 1999 to 2005 were analyzed. These patients were classified into patients with disable and patients without disabed. The factors potentially impacting on outcomes were analyzed. Results The overall inci-dence of TCCF in 312 patients with fracture of basilaris cranii was 3.8% .The incideucs of TCCF occurred in pa-tients with the fracture of anterior fossa, middle fossa and posterior fossa accounted for 2.4%, 8.3 % and 1.7 %, respectively. Between two cohorts of patients, there were no difference in age, gender, number of embelization proce-dares performed and the time from injury to appearence of the first symptom except the differencc in time from ap-pearence of the first symptom to the intravascular embohzation performed (P>0.05). Conclusions A relatively high incidence of TCCF occurs in patients with middle fossa fractures, especially those with transverse or oblique fractures. Prompt diagnosis and intervention can not be emphasized in case of patients with TCCF, and non inva-sive techniques for the early detection of TCCF under certain circumstance after brain or facial trauma should be considered so as to avoid a miss in the early diagnosis of middle fossa fracture to ensure favourable outcomes.