Linear fractures of the cranium: follow-up and management results of 442 cases

Abstract

Aim: We aimed to evaluate the clinical and radiological follow-up of cases with isolated linear fractures detected in the cranium in the post-traumatic period, to determine on which cases and when to perform control radiological examinations and to suggest follow-up protocol. Material and Method: 442 cases with isolated linear cranium fracture were evaluated in the study. Imaging examinations and clinical findings of the cases at the time of admission were compared with radiological examinations and clinical findings at follow-up. Fracture localizations and trauma types were compared. Accompanying maxillofacial fractures depending on the localization of fractures detected in the cranium were determined. Results: In the follow-up CT examinations of 18 out of 442 cases, cerebral contusion in 12 cases and epidural hematoma in 1 case, not detected during initial admission were found. Post-traumatic epilepsy was observed in 4 cases without radiologic findings. In cases receiving follow-up radiological examinations, no significant difference was found between radiological examinations performed during 4-6 hours versus 12-24 hours after trauma. Discussion: Isolated linear fracture cases do not require neurosurgical intervention. The treatment protocol may change depending on findings during the follow-up period. Performing routine follow-up radiological examinations is not cost-effective in cases in which no additional finding is present, and symptoms do not persist.