Publication Type Review
Authors Bullock M, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell D, Servadei F, Walters B, Wilberger J
Journal Neurosurgery
Volume 58
Issue 3 Suppl
Pagination S56-60; discussion Si-iv
Date Published 03/01/2006
ISSN 1524-4040
Keywords Neurosurgical Procedures, Skull Fractures
Abstract INDICATIONS: Patients with open (compound) cranial fractures depressed greater than the thickness of the cranium should undergo operative intervention to prevent infection. Patients with open (compound) depressed cranial fractures may be treated nonoperatively if there is no clinical or radiographic evidence of dural penetration, significant intracranial hematoma, depression greater than 1 cm, frontal sinus involvement, gross cosmetic deformity, wound infection, pneumocephalus, or gross wound contamination. Nonoperative management of closed (simple) depressed cranial fractures is a treatment option. TIMING: Early operation is recommended to reduce the incidence of infection. METHODS: Elevation and debridement is recommended as the surgical method of choice. Primary bone fragment replacement is a surgical option in the absence of wound infection at the time of surgery. All management strategies for open (compound) depressed fractures should include antibiotics.
DOI 10.1227/01.NEU.0000210367.14043.0E
PubMed ID 16540744
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