There is high Incidence of Skull Fracture associated with Extradural Hematoma in Patients with Head Injury

Objective: To determine the correlation of skull fracture with extradural hematoma in head injury patients presenting to a tertiary care hospital in Pakistan. Patients and Methods: This descriptive study was carried out at Shifa International Hospital, Islamabad from January 2002 to January 2007. All patients who were operated for extradural hematoma during the study period were included in the study. Standard skull X-rays were done and type and location of fractures were noted on X-rays, CT scan and per-operatively. The incidence of skull fracture associated with extradural hematoma in various age groups was noted. The results were analyzed using SPSS version 14.0. Results: A total of 110 patients underwent surgery for extradural hematoma. A linear fracture was demonstrated in 60 patients and a depressed skull fracture in 15 patients. Another 8 patients who did not have radiologically visible fracture were found to have a fracture line per-operatively. Thus, a total of 83 (75%) patients had skull fracture. There was no statistically significant difference in the incidence of skull fracture in various age groups. Conclusion: There is a strong association of skull fracture to extradural hematoma, however, a normal X-ray does not exclude extradural hematoma. (Rawal Med J 2008;33:228-230).