Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Lesiones por Contragolpe , Ecocardiografía Transesofágica/métodos , Aneurisma Cardíaco , Lesiones Cardíacas , Traumatismo Múltiple , Tabique Interventricular , Adolescente , Lesiones por Contragolpe/diagnóstico , Lesiones por Contragolpe/fisiopatología , Lesiones por Contragolpe/terapia , Aneurisma Cardíaco/diagnóstico por imagen , Aneurisma Cardíaco/etiología , Aneurisma Cardíaco/cirugía , Lesiones Cardíacas/sangre , Lesiones Cardíacas/diagnóstico , Lesiones Cardíacas/fisiopatología , Hemoneumotórax/diagnóstico , Hemoneumotórax/etiología , Hemoneumotórax/cirugía , Humanos , Hemorragia Intracraneal Traumática/diagnóstico , Hemorragia Intracraneal Traumática/etiología , Hemorragia Intracraneal Traumática/cirugía , Imagen por Resonancia Cinemagnética/métodos , Masculino , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/fisiopatología , Traumatismo Múltiple/terapia , Manejo de Atención al Paciente/métodos , Resultado del Tratamiento , Troponina T/sangre , Tabique Interventricular/diagnóstico por imagen , Tabique Interventricular/lesiones , Tabique Interventricular/patologíaRESUMEN
OBJECTIVE: To study the prevalence and patterns of contrecoup injury in traumatic temporal bone fracture cases. METHOD: A prospective, cohort study was undertaken of all patients with traumatic head injury admitted to a tertiary referral hospital in Malaysia within an 18-month period. High resolution computed tomography scans of the brain and skull base were performed in indicated cases, based on clinical findings and Glasgow coma score. Patients with a one-sided temporal bone fracture were selected and subsequent magnetic resonance imaging performed in all cases. Contrecoup injury incidence, type, severity and outcome were recorded. RESULTS: Of 1579 head injury cases, 81 (5.1 per cent) met the inclusion criteria and were enrolled in the study. Temporal bone fractures were significantly associated with intracranial injuries (p < 0.001). The incidence of a contrecoup injury in cases with temporal bone fracture was 13.6 per cent. Contrecoup injury was significantly associated with petrous temporal bone fracture (p < 0.01). The commonest contrecoup injury was cerebral contusion, followed by extradural haematoma and subdural haematoma. CONCLUSION: Contrecoup injury is not uncommon in cases of temporal bone fracture, and is significantly associated with petrous temporal bone fracture.