Contrecoup injury in patients with traumatic temporal bone fracture
Z A Asha'Ari1, R Ahmad, J Rahman
1Department of Otorhinolaryngology-Head and Neck Surgery, International Islamic University Malaysia, Jalan Hospital, Kuantan, Pahang, Malaysia. zamzilamin@yahoo.com
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.
