Kranial bilgisayarlı tomografi incelemesinde izlenemeyen ve direkt grafide saptanan kranial fraktür olgusu

Günümüzde kafa travmalarında artık direkt grafinin yeri olmadığına dair görüşler vardır. Fakat transvers kalvaryal fraktürleri BT’de tespit etmek zordur. Düşme sonrası kafa travmasıyla bir merkeze başvuran, çekilen kranial BT’de kırık hattı izlenmeyen olgu sunulmuştur. Baş ağrısı, bulantı-kusma, şikayetiyle acil servisimize başvuran hastanın muayenesi normaldi. Direkt kraniografik incelemede sağ frontal lineer fraktür hattı izlenen hasta takip amacıyla yatırıldı. Hukuki nedenlerle ve transvers kırıkların BT’de saptanmama olasılığı nedeniyle kliniğimizde rutin olarak hafif kafa travması dahi olsa, kafa travmasıyla başvuran tüm olgulara kraniografi çekilmektedir.

Cranial fracture that was diagnosed with direct graphy but not detected in cranial computerized tomography

Nowadays, there are some ideas that direct graphy is unnecessary for the evaluation of patients with head trauma. But, computerized tomography (CT) is less sensitive in detection of calvarial skull fractures than plain radiographs. We report a case who was admitted to hospital after fall and skull fracture was not detected with CT. Neurologic examination of the patient was normal when he was referred to our emergency department with complaints of headache, nausea, and vomiting. Plain radiograph showed right frontal lineer fracture so the patient was hospitalized. All cases who apply with head trauma are routinely evaluated with direct cranial graphy in our clinic because of legal conditions and the probability that transverse fractures may not be detected with CT.

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  • 1. Hofman PA, Nelemans P, Kemerink GJ, Wilmink JT. Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis. J Neurol Neurosurg Psychiatry 2000; 68: 416-422.
  • 2. Thillainayagam K, MacMillan R, Mendelow AD et al. How accurately are fractures of the skull diagnosed in an accident and emergency department. Injury 1987;18: 319-321.
  • 3. Benham J, Chavda SV. Head trauma. Trauma 2004; 6: 101-110.
  • 4. Roger LF. (ed). Radiology of skeletal trauma. New York, Churchill Livingstone, 1992.
  • 5. Yavuz MS, Aşırdizer M, Ağırbaş AÇ, Altınkök M. Klinik Adli Tıp 2001; 2: 81-88.