CLINICAL CHARACTERISTICS OF TRAUMATIC BASAL SKULL FRACTURE IN ROAD TRAFFIC ACCIDENTS

*Dr. Adarsh Trivedi

ABSTRACT

Road traffic accidents (RTAs) have emerged into the list of top 10 causes of mortality in the world. Basal skull fractures (BSF) are alarming injuries resulting from fractures in the bones of the skull base and these fractures are often associated with dural tears. These results in cerebrospinal fluid (CSF) fistula. The pattern and cause of BSF and pattern of CSF leak is also different in various parts. Material and Methods: History of patients admitted to the neurosurgery department who were diagnosed of TBI was taken thoroughly. Demographic variables like age, sex, place of residence were taken. Glasgow Coma Scale (GCS) score was recorded. Patients were evaluated with repeated clinical examinations during the course of the hospital stay. Clinical features in the form of ear bleed or nose bleed at the time of admission, postauricular ecchymosis, raccoon eyes, and CSF leak if any were recorded. Results: 1413 patients with TBI were admitted to the neurosurgery department. Out of which only 64 patients had BSF. According to severity of head injury Mild, moderate and severe were 20(31.25%), 28(43.75%), 16(25.00%) respectively. Maximum mortality was observed in severe injuries 3 (4.69%). Clinically 28(43.75%) had Subconjunctival hemorrage, 41(64.06%) had Raccon eye and 12(18.75%) had post auricular ecchymosis. Most of the BSF were observed in the 17-30 age groups. Conclusion: BSF was mostly observed in the young male population. Clinical signs of BSF are supportive. CSF leak can be managed conservatively. Mortality was 7.81% with the majority of deaths occurring among young age group.

Keywords: TBI, Basal Skull Injury (BSI), CSF, CT.