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J Korean Soc Emerg Med > Volume 27(6); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(6): 514-521.
안면 손상의 위치와 외상성 뇌 출혈과의 관계
박상협1, 한승백1, 서영주2, 강수1, 김아름1, 이형민1, 김아진1*
1인하대학교병원 응급의학과
2인하대학교 의과대학 의생명과학교실
The Relationship of the Facial Injury Location and the Traumatic Brain Hemorrhage
Sang Hyub Park1, Seung Baik Han1, Young Ju Suh2, Soo Kang1, Areum Durey Kim1, Hyung Min Lee1, Ah Jin Kim1*
1Department of Emergency Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
2Department of Biomedical Science, Inha University School of Medicine, Incheon, Korea
Correspondence  Ah Jin Kim ,Tel: 032-890-2310, Fax: 032-890-2314, Email: emjin23@naver.com,
Received: June 29, 2016; Revised: June 30, 2016   Accepted: September 2, 2016.  Published online: December 31, 2016.
Several studies have reported that facial fractures were associated with traumatic brain injuries or cervical injuries. The purpose of this study was to analyze the relationship between the location of facial injury and traumatic brain hemorrhage in order to support future decisions for image evaluation in facial injury patients.
In this retrospective cohort study, we evaluated facial injury patients without external head trauma who visited the emergency department at our hospital between January 1, 2014 and October 31, 2014. We divided the cohort into 2 groups: Facial injury patients with associated traumatic brain hemorrhage and those without traumatic brain hemorrhage. We compared the factors related to traumatic brain hemorrhage, such as facial injury locations, mechanism of accident, types of wounds, altered mentality, headache, and loss of consciousness between the two groups.
In 873 patients, 73 (8.36%) presented traumatic brain hemorrhage and the other 800 had no traumatic brain hemorrhage on a brain computed tomography (CT) scan. The rate of headache, loss of consciousness, altered mentality, traffic accident, fall down, fracture, temporal injury, frontal injury, multiple facial area injury, and upper facial area (frontal and upper orbital area) injury were higher in the traumatic brain hemorrhage group than in the non-traumatic brain hemorrhage group (p<0.05). The risk factors of traumatic brain hemorrhage were headache, loss of consciousness, altered mentality, facial bone fracture, and temporal area injury of the face.
If a facial injury patient has any of the following factors temporal area injury, facial bone fracture, altered mentality, headache, and loss of consciousness, we have to evaluate the brain CT scan even if the patient had no external head injury.
Key words: Fracture, Trauma, Temporal bone, Traumatic brain injury
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