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LETTER TO EDITOR
Year : 2018  |  Volume : 13  |  Issue : 2  |  Page : 528

Do we need to include “Elevated Skull Fractures” in skull fracture classification?


Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India

Date of Web Publication26-Mar-2018

Correspondence Address:
Amit Agrawal
Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore - 524 003, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1793-5482.228553

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How to cite this article:
Agrawal A. Do we need to include “Elevated Skull Fractures” in skull fracture classification?. Asian J Neurosurg 2018;13:528

How to cite this URL:
Agrawal A. Do we need to include “Elevated Skull Fractures” in skull fracture classification?. Asian J Neurosurg [serial online] 2018 [cited 2020 May 29];13:528. Available from: http://www.asianjns.org/text.asp?2018/13/2/528/228553



Sir,

We read the article which deals with the elevated skull fractures in pediatric age group.[1] Elevated skull fractures are increasingly recognized as a distinct entity in many recent articles. The present article is unique and discusses the issues in the management in pediatric age group. The early recognition and appropriate management of compound elevated fracture resulted in good recovery without any complications. It is evident from the present series that the elevated skull fractures result from a tangential force which causes elevation of the bone fragment (in contrary to depressed skull fractures). Except the elevated nature of the bone fragments, almost all other management principles follow as for depressed skull fractures. One important and interesting point which can be debated is the amount of contamination (which the authors claim to be more in depressed fractures than in elevated skull fractures).[1] A good outcome of these patients is attributed to the fact that tangential force causes less energy to the brain parenchyma.[1],[2],[3] However, it may not be true in the cases, the underlying mechanism if severe enough can result in fatal injuries.[4] Based on the availability of good amount of literature, it can be suggested that there is a need to consider elevated skull fractures in the classification of skull fractures.[5],[6]

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Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kumar J, Prakash A, Harsh V, Kumar A. Elevated fracture of skull in pediatric age group: A series of five patients with review of literature. Asian J Neurosurg 2016;11:105.  Back to cited text no. 1
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2.
Agrawal A. Elevated skull fracture. Panam J Trauma Crit Care Emerg Surg 2014;3:85.  Back to cited text no. 2
    
3.
Garg N, Devi BI, Maste P. Elevated skull fracture. Indian J Neurotrauma 2007;4:133.  Back to cited text no. 3
    
4.
Agrawal A, Subrahmanyan BV, Rao GM. Blast injury causing extensive brain injury and elevated skull fracture. Indian J Neurotrauma 2014;11:64-7.  Back to cited text no. 4
    
5.
Adeolu AA, Shokunbi MT, Malomo AO, Komolafe EO, Olateju SO, Amusa YB. Compound elevated skull fracture: A forgotten type of skull fracture. Surg Neurol 2006;65:503-5.  Back to cited text no. 5
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6.
Agrawal A, Kumar SS, Reddy UV, Hegde KV, Subrahmanyan BV. Compound elevated skull fracture: Should we incorporate in skull fracture classification? Int J Crit Illn Inj Sci 2015;5:227-9.  Back to cited text no. 6
[PUBMED]  [Full text]  




 

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