Contrecoup Skull Fracture.

Lee, Young Woo

Original Article

Journal of Korean Neurosurgical Society 1977;6(2): 459-464.

Department of Neurosurgery, Busan National University School of Medicine, Korea.

ABSTRACT

The author experienced 21 cases of contrecoup skull fracture who were admitted to Department of Neurosurgery, Busan National University Hospital in recent 2 years. The clinical analysis, causes of cranial impact, the point of cranial impact, fracture at the point of impact, diagnosis, prognosis and mechnisms were reviewed. The results were summarized as the follows : 1) Age distribution was ranged from 12 year to 64. The contrecoup skull fracture was prominent on the twenties and thirties. It was dominant in male and ratio of male to female was 14 to 7. 2) Causes of cranial impact were mainly fall, and tumbling down and heavy matter drop on the head. 3) The point of cranial impact were most frequent at parieto-occipital region, and vertex, bregma and occipital region. 4) Of 21 cases of the contrecoup skull fracture, 18 had the direct fracture at the point of impact, but 3 who were diagnosed cerebral concussion did not have a fracture at the point of impact. 5) Of 21 cases of the contrecoup skull fracture, fossa fractured was 20 in anterior fossa and 7 in middle fossa. 6) Diagnosis of the contrecoup skull fracture was made by skull X-ray and varous clinical findings, such as fracture, 3 had concussion, 6 skull fracture, 2 epidural hematoma, 7 subdural hematoma, and 3 intracerebral hemorrhage. 7) The mortality was 19 percent and it was correlated with the initial injury. In general prognosis in survival was good or fair. 8) The anatomical characteristics of cranial fossa, clinical feature and mechanism of the contrecoup skull fracture were discussed.