"High risk" anterior basal skull fractures. Surgical treatment of 64 consecutive cases.

摘要: Anterior Basal Skull Fractures (ABSFs) may be complicated by Cerebrospinal Fluid (CSF) fistulae and intracranial infections. An initially non-operative management is usually suggested since most spontaneously stop within a few days thus requiring no surgical repair. However, if the fistula fails to or recurs, treatment considered. Furthermore, fracture meningitis, there relative risk of recurring infections repair also Finally, in cases compound, comminuted, depressed, largely extended cranio-facial fractures (the so-called "fracas craniofaciaux") where spontaneous healing considered unlikely infection high. Accordingly we termed "high risk" those associated with active (persistent recurring) cerebrospinal fluid fistula, meningitis craniofaciaux". In this paper, report our personal experience 64 consecutive anterior basal skull fractures. Thirty-seven patients had persistent fistulae, ten seventeen severe bone derangement base. The osteodural repairs were performed through bilateral unilateral subfrontal approach. 59 initial procedure was successful whereas 4 patient needed additional surgery but ultimately successfully treated. One died. No major permanent neurologic neuropsychologic impairments reported. On basis experience, think that very suitable modality facing