Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T02:57:51.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Contrecoup injury in patients with traumatic temporal bone fracture

Published online by Cambridge University Press:  27 April 2011

Z A Asha'Ari ,
R Ahmad ,
J Rahman ,
N Kamarudin  and
L Wan Ishlah
Z A Asha'Ari*
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, International Islamic University Malaysia, Jalan Hospital, Kuantan, Pahang, Malaysia
R Ahmad
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, International Islamic University Malaysia, Jalan Hospital, Kuantan, Pahang, Malaysia
J Rahman
Affiliation:
Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Hospital, Kuantan, Pahang, Malaysia
N Kamarudin
Affiliation:
Department of Radiology, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
L Wan Ishlah
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, International Islamic University Malaysia, Jalan Hospital, Kuantan, Pahang, Malaysia
*
Address for correspondence: Dr Zamzil Amin Asha'Ari, Assistant Professor, Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, International Islamic University Malaysia, Jalan Hospital, 25100 Kuantan, Pahang, Malaysia Fax: 609 5133615 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To study the prevalence and patterns of contrecoup injury in traumatic temporal bone fracture cases.

Method:

A prospective, cohort study was undertaken of all patients with traumatic head injury admitted to a tertiary referral hospital in Malaysia within an 18-month period. High resolution computed tomography scans of the brain and skull base were performed in indicated cases, based on clinical findings and Glasgow coma score. Patients with a one-sided temporal bone fracture were selected and subsequent magnetic resonance imaging performed in all cases. Contrecoup injury incidence, type, severity and outcome were recorded.

Results:

Of 1579 head injury cases, 81 (5.1 per cent) met the inclusion criteria and were enrolled in the study. Temporal bone fractures were significantly associated with intracranial injuries (p < 0.001). The incidence of a contrecoup injury in cases with temporal bone fracture was 13.6 per cent. Contrecoup injury was significantly associated with petrous temporal bone fracture (p < 0.01). The commonest contrecoup injury was cerebral contusion, followed by extradural haematoma and subdural haematoma.

Conclusion:

Contrecoup injury is not uncommon in cases of temporal bone fracture, and is significantly associated with petrous temporal bone fracture.

Keywords

Temporal BoneSkull FracturesBrain InjuriesContrecoup InjuryDiagnosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 8 , August 2011 , pp. 781 - 785
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Poirier, MP. Concussions: assessment, management, and recommendations for return to activity. Clin Pediatr Emerg Med 2003;4:179–85CrossRefGoogle Scholar
2Morrison, AL, King, TM, Korell, MA, Smialek, JE, Troncoso, JC. Acceleration-deceleration injuries to the brain in blunt force trauma. Am J Forensic Med Pathol 1998;19:109–12CrossRefGoogle Scholar
3Hardman, JM, Manoukian, A. Pathology of head trauma. Neuroimaging Clin N Am 2002;12:175–87CrossRefGoogle ScholarPubMed
4Mitsuyama, T, Ide, M, Kawamura, H. Acute epidural hematoma caused by contrecoup head injury. Neurol Med Chir 2004;44:584–6CrossRefGoogle ScholarPubMed
5Hardin, MF. A case of contrecoup vestibular injury. Kans Med 1996;97:14–15Google ScholarPubMed
6Balasubramaniam, V, Ramesh, VG. A case of coup and contrecoup extradural hematoma. Surg Neurol 1991;36:462–4CrossRefGoogle ScholarPubMed
7Jones, RM, Rothman, MI, Gray, WC, Zoarski, GH, Mattox, DE. Temporal lobe injury in temporal bone fractures. Arch Otolaryngol Head Neck Surg 2000;126:131–5CrossRefGoogle ScholarPubMed
8Ulug, T, Ulubil, SA. Contralateral labyrinthine concussion in temporal bone fractures. J Otolaryngol 2006;35:380–3CrossRefGoogle ScholarPubMed
9Ryan, GA, McLean, AJ, Vilenius, AT, Kloeden, CN, Simpson, DA, Blumbergs, PC et al. Brain injury patterns in fatally injured pedestrians. J Trauma 1994;36:469–76CrossRefGoogle ScholarPubMed
10Lee, HJ, Lum, C, Means, K, Chandrasekhar, S, Brown, L, Holodny, A et al. Temporal bone fractures and complications: correlation between high-resolution computed tomography and audiography. Emerg Radiol 1998;5:8–12CrossRefGoogle Scholar
11Saraiya, PV, Aygun, N. Temporal bone fractures. Emerg Radiol 2009;16:255–65CrossRefGoogle ScholarPubMed
12Brodie, HA, Thompson, TC. Management of complications from 820 temporal bone fractures. Am J Otol 1997;18:188–97Google ScholarPubMed
13Yavuz, MS, Asirdizer, M, Cetin, G, Balci, YG, Altinkok, M. The correlation between skull fractures and intracranial lesions due to traffic accidents. Am J Forensic Med Pathol 2003;24:339–45CrossRefGoogle ScholarPubMed
14Ishman, SL, Friedland, DR. Temporal bone fractures: traditional classification and clinical relevance. Laryngoscope 2004;114:1734–41CrossRefGoogle ScholarPubMed
15Besenski, N. Traumatic injuries: imaging of head injuries. Eur Radiol 2002;12:1237–52CrossRefGoogle ScholarPubMed
16Drew, LB, Drew, WE. The contrecoup-coup phenomenon: a new understanding of the mechanism of closed head injury. Neurocrit Care 2004;4:385–90CrossRefGoogle Scholar
17Gurdjian, E, Gurdjian, ES. Cerebral contusions: re-evaluation of the mechanism of their development. J Trauma 1976;16:35–51CrossRefGoogle ScholarPubMed
18Dahiya, R, Keller, JD, Litofsky, NS, Bankey, PE, Bonassar, LJ, Megerian, CA. Temporal bone fractures: otic capsule sparing versus otic capsule violating clinical and radiographic considerations. J Trauma 1999;47:1079–83CrossRefGoogle ScholarPubMed