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Likvorea in pediatric patients with craniocerebral injury


Authors: Eva Brichtová;  David Starý;  Ladislav Plánka;  Štěpánka Bibrová;  Bronislav Hnilička
Authors place of work: Department of Pediatric Surgery, Orthopedics and Traumatology, University Hospital Brno ;  Klinika dětské chirurgie, ortopedie a traumatologie FN Brno
Published in the journal: Úraz chir. 18., 2010, č.1

Summary

Introduction:
Fractures of the skull base may occur alone or continuing calvariar fissures into the base of the skull. Dura mater adheres firmly to the cranial base, therefore dural rupture occurs during fractures and intracranium communication with the external environment and likvorea are developed.

Material and methods:
The authors present a set of 19 pediatric patients suffering from likvorea after the skull base fracture during the period of 7 years. 11 patients experienced otorrhea, 6 patients nasal likvorea and 2 patients a combination of rhinorrhea and otorrhea.

Results:
15 patients (79%) were treated conservatively, 4 patients (21%) in the age groups 15-18 years underwent emergency neurosurgical treatment with the skull base duroplasty. In one patient with anterior cranial fossa fracture post-traumatic meningitis occured, which was treated conservatively by using antibiotics.

Conclusion:
In pediatric patients, lower likvorea incidence than in adults is reported. Yet likvorea remains a serious post-traumatic condition, which results in breach of the central nervous system and outer environment barrier with intracranial infection threat.

Keywords:
likvorea, craniocerebral injury, fracture of the skull base, rhinorrhea, otorrhea, meningitis, childhood, skull base duroplasty.


Zdroje

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Štítky
Surgery Traumatology Trauma surgery
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