Skip to main content

Advertisement

Log in

Elevated Skull Fractures: an Under-Recognized Entity

  • Review Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Elevated skull fractures form a rare subset of compound skull fractures. Owing to the paucity of cases studied and reported, these fractures still remain an under-recognized entity. We attempt to highlight the incidence of these relatively rare presentations of head injury. We had prospectively studied eight cases of elevated skull fractures in a mixed population of adults (five patients) and pediatric age group (three patients). Patients were evaluated in terms of clinical presentation, mode and mechanism of injury, treatment options, and final outcome, highlighting the appropriate management strategies taken in each case. The injury in these patients was due to tangential impact of a heavy object or assault weapon. Compounding of the fracture externally and dural tears was an inconstant feature. Associated intracranial injuries were cerebral contusions and extradural hematomas. An initial conservative therapy was given to all pediatric patients while adult patients underwent explorative craniectomy and evacuation of hematoma. Although an unusual presentation of skull fractures, elevated skull fractures warrant an early diagnosis, careful clinical evaluation, and prompt surgical therapy (whenever needed) for a successful outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

GCS:

Glasgow Coma Scale

pGCS:

Pediatric Glasgow Coma Scale

CSF:

Cerebrospinal fluid

NCCT:

Non-contrast computed tomography

References

  1. Geisler FH (1996) Skull fractures. In: Wilkins RH, Rengachary SS (eds) Neurosurgery vol II. McGraw Hill, New York, pp 2741–2754

    Google Scholar 

  2. Breasted JH (1930) The Edwin Smith Surgical Papyrus. Facsimile and hieroglyphic transliteration with translation and commentary, in two volumes. University of Chicago Press, Chicago

    Google Scholar 

  3. Sanchez GM, Burridge AL (2007) Decision making in head injury management in the Edwin Smith Papyrus. Neurosurg Focus 23(1):1–9

    Article  Google Scholar 

  4. Ralston BL (1976) Compound elevated fractures of skull. J Neurosurg 44:77–79

    Article  CAS  PubMed  Google Scholar 

  5. Chhiber SS, Wani MA, Kirmani AR et al (2011) Elevated skull fractures in pediatric age group: report of two cases. Turk Neurosurg 21(3):418–420

    PubMed  Google Scholar 

  6. Adeolu AA, Shokumbi MT, Malomo AO et al (2006) Compound elevated skull fracture: a forgotten type of skull fracture. Surg Neurol 65:503–505

    Article  PubMed  Google Scholar 

  7. Sharma R, Kumar A, Bhat DI et al (2012) Compound elevated skull fractures in adults: a series of five patients and review of literature. Indian J Neurotrauma 9:112–116

    Article  Google Scholar 

  8. Borkar SA, Sinha S, Sharma BS (2009) Post-traumatic compound elevated fracture of skull simulating a formal craniotomy. Turk Neurosurg 19(1):103–105

    PubMed  Google Scholar 

  9. Borkar SA, Prasad GL, Gupta DK et al (2013) Compound elevated skull fracture: a clinical series of three patients with a review of the literature. Turk Neurosurg 23(4):514

    PubMed  Google Scholar 

  10. Mohindra S, Singh H, Savardekar A (2012) Importance of an intact dura in management of compound elevated fractures: a short series and literature review. Brain Inj 26(2):194–198

    Article  PubMed  Google Scholar 

  11. Khandaker AT, Selvapandian S, Khan A et al (2009) Compound elevated skull fracture with occlusion of the superior sagittal sinus. A case report. Kobe J Med Sci 54(5):260–263

    Google Scholar 

  12. Sharma R, Saligouda P, Bhat DI et al (2012) Compound elevated skull fracture mimicking a frontotemporoorbitozygomatic craniotomy flap. Neurol India 60(4):448–449

    Article  PubMed  Google Scholar 

  13. Bhaskar S (2010) Compound “elevated” fracture of the cranium. Neurol India 58(1):149–151

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akshat Kayal.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gupta, R., Iyengar, R., Kayal, A. et al. Elevated Skull Fractures: an Under-Recognized Entity. Indian J Surg 77 (Suppl 3), 1308–1312 (2015). https://doi.org/10.1007/s12262-014-1093-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-014-1093-7

Keywords

Navigation