Outcome of patients operated for depressed skull fracture with dural tear

Abstract

Objective:  The objective of this study was to determine the outcome of patients operated for depressed skull fracture with a dural tear. Material and Methods:  A descriptive case series (n = 155) was carried out in the Department of Neurosurgery, Hayatabad Medical Complex Peshawar for six months. Results:  The mean arrival GCS was 10.64 ± 2.33. About 21.9% (n = 32) patients presented with a GCS of ? 8, while the remaining 78.1% (n = 123) presented with a GCS of ? 8. About 8.4% (n = 13) patients died due to the complications of the brain injury. The most common postoperative complication was found to be progressive neurologic deficit (PND) occurred in 21 (13.5%) patients. Penetrating injury to the head was also associated with unfavorable outcomes after surgery (p = 0.046), which shows that penetrating injury is associated with increased brain damage and hence consequently poor outcomes. Conclusions:  The neurologic status as denoted by the Glasgow coma scale is one of the most important factors which predicts the outcome. Surgical management of depressed skull fractures with dural tear has favorable outcomes in about two-thirds of patients. The remaining one-third patient remains in the severely disabled group. Every effort should be made to reduce the occurrence of complications as they are directly related to postoperative functional outcomes.