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Traumatic Brain Injury in Patients With Frontal Sinus Fractures.

Pharibe Pope1, Bashar Hassan2, Kimberly Oslin1

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The Journal of Craniofacial Surgery
|June 28, 2024
PubMed
Summary
This summary is machine-generated.

Traumatic brain injury (TBI) is common in frontal sinus fractures, especially with combined anterior/posterior fractures. Many patients experience persistent neurological issues, underscoring the need for high suspicion and imaging in these cases.

Keywords:
Craniofacial traumafacial traumafrontal sinus fracturetraumatic brain injury

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Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Traumatic brain injury (TBI) is a significant cause of neurological impairment.
  • Frontal sinus fractures are associated with a high incidence of TBI, yet risk factors are understudied.
  • Understanding these risks is crucial for timely diagnosis and management.

Purpose of the Study:

  • To evaluate the prevalence of TBI at presentation in patients with frontal sinus fractures.
  • To identify risk factors for TBI and persistent neurological sequelae in this patient group.
  • To inform clinical practice regarding diagnosis and follow-up.

Main Methods:

  • Retrospective review of patients with frontal sinus fractures in 2019.
  • Defined TBI based on neurological symptoms, signs, or Glasgow Coma Scale <15.
  • Utilized bivariate analysis and multivariate logistic regression to identify risk factors.

Main Results:

  • 82.1% of patients with frontal sinus fractures had concomitant TBI.
  • Combined anterior and posterior table fractures significantly increased TBI odds (aOR 12.7).
  • 70.6% experienced persistent neurological sequelae; orbital roof fractures increased sequelae odds (aOR 32).

Conclusions:

  • High prevalence of TBI in frontal sinus fractures necessitates vigilance.
  • Combined table fractures and orbital roof fractures are key indicators for TBI and sequelae.
  • Recommend head CT and close neurological follow-up for high-risk patients.