Management of depressed skull fractures overlying dural venous sinuses / Amr Mohamed Selim Hashad ; Supervised Khaled Samir Anbar , Mohamed Amr Altayeb , Ahmad Assem Farid

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

The most commonly described indications for surgical management of closed depressed skull fractures are hematoma evacuation and repair of extensive cosmetic deformity especially in the frontal bone inferior to hair line and venous sinus compromise.Compound depressed fracture over a cranial sinus treated surgically because of suspected dural breech and to reduce the high risk of infection as some authors reported that many cases of compound skull fractures had dural tear moreover sinus laceration is not common and most of cases bleeding is controlled by direct gelfoam compression for few minutes also elevation of depressed fragment reduce the risk of sinus compromise.Post traumatic dural sinus thrombosis is considered a rare complication which may lead to hemorrhagic infarction with its serious consequences including epilepsy, neurological deficits, or death Recommendations: surgical treatment of a compound depressed fracture over a cranial sinus is preferred to reduce the high risk of sepsis. On the other hand, We feel like a more conservative approach to a simple depressed fracture is preferred provided that no sinus compromise

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