Patterns of brain injuries associated with maxillofacial fractures and its fate in emergency Egyptian polytrauma patients

Chin J Traumatol. 2018 Oct;21(5):287-292. doi: 10.1016/j.cjtee.2017.12.005. Epub 2018 Sep 8.

Abstract

Purpose: Maxillofacial injuries are commonly encountered in the practice of emergency medicine. More than 50% of patients with these injuries have multisystem trauma that requires coordinated management between emergency physicians and surgical specialists in oral and maxillofacial surgery, otolaryngology, plastic surgery, ophthalmology, and trauma surgery. The aim of this study is to identify the patterns of brain injuries associated with maxillofacial trauma and its outcome.

Methods: This descriptive study (cross-sectional) was carried out among 90 polytrauma patients with maxillofacial fractures attending the Emergency Department at Suez Canal university Hospital and fulfilling our inclusion and exclusion criteria.

Results: This study demonstrates the relation between type of maxillofacial fracture and type of traumatic brain injuries in which the majority of patients with epidural hemorrhage presented with mid face fractures (60%), while the minority of them presented with upper and lower face fractures (20% for each of them). The majority of patients with subdural hemorrhage were associated with mid face fractures (75%), the majority of patients with brain contusions associated with mid face fractures (75%), and all of the patients presented by pneumocephalus were associated with mid face fractures (100%).

Conclusion: The results of this study confirm the value of quick diagnosis and early intervention, which is fundamental to prevent morbidity as well as mortality especially with regards to prevention of traumatic brain injury as even a short duration of hypoxia and edema will lead to significant permanent neurological deficits.

Keywords: Brain injuries; Maxillofacial fractures; Outcome.

MeSH terms

  • Adolescent
  • Adult
  • Brain Injuries, Traumatic / diagnosis
  • Brain Injuries, Traumatic / mortality
  • Brain Injuries, Traumatic / therapy*
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Developing Countries
  • Egypt
  • Emergency Service, Hospital
  • Female
  • Fracture Fixation / methods
  • Hospital Mortality / trends*
  • Hospitals, University
  • Humans
  • Injury Severity Score
  • Male
  • Maxillofacial Injuries / diagnostic imaging
  • Maxillofacial Injuries / mortality
  • Maxillofacial Injuries / therapy*
  • Middle Aged
  • Multiple Trauma / mortality
  • Multiple Trauma / therapy*
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome
  • Young Adult