Subject(s)
Cardiac Surgical Procedures/methods , Contrecoup Injury , Echocardiography, Transesophageal/methods , Heart Aneurysm , Heart Injuries , Multiple Trauma , Ventricular Septum , Adolescent , Contrecoup Injury/diagnosis , Contrecoup Injury/physiopathology , Contrecoup Injury/therapy , Heart Aneurysm/diagnostic imaging , Heart Aneurysm/etiology , Heart Aneurysm/surgery , Heart Injuries/blood , Heart Injuries/diagnosis , Heart Injuries/physiopathology , Hemopneumothorax/diagnosis , Hemopneumothorax/etiology , Hemopneumothorax/surgery , Humans , Intracranial Hemorrhage, Traumatic/diagnosis , Intracranial Hemorrhage, Traumatic/etiology , Intracranial Hemorrhage, Traumatic/surgery , Magnetic Resonance Imaging, Cine/methods , Male , Multiple Trauma/diagnosis , Multiple Trauma/physiopathology , Multiple Trauma/therapy , Patient Care Management/methods , Treatment Outcome , Troponin T/blood , Ventricular Septum/diagnostic imaging , Ventricular Septum/injuries , Ventricular Septum/pathologyABSTRACT
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.