Skull fracture: an indicator of life-threatening injury or a predictor of intracranial injury?


  • Eugene Pedachenko Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Vasyl Burchynskyi Main Office of Forensic Medicine of Ukraine, Ministry of Health of Ukraine, Kiev, Ukraine
  • Nikolay Kadzhaya Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Andriy Huk Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Andrey Diadechko Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Dmytro Kuzmenko Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Andrii Boliukh Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Oleksandr Gotin Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Oksana Skobska Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Oleg Robak Romodanov Neurosurgery Institute, Kiev, Ukraine



skull bones fracture, intracranial lesions, severity of traumatic brain injury, forensic examination


Purpose. To provide arguments that would allow to bring existing today in forensic medicine evaluation of the severity of traumatic brain injury (TBI) to clinical practice.

Materials and methods. A retrospective analysis of 280 cases histories of patients been treated for TBI was provided, and 131 autopsy protocols of dead from severe TBI. Clinical evaluation of TBI severity was made according to the Glasgow Coma Scale and TBI classification. The data were statistically processed using c2.

Results. The analysis of skull fractures localization showed that mild TBI is characterized by fracture of one bone — in 38 (78.9%) cases and skull vault — in 45 (91.8%). At moderate and severe TBI fractures are localized in several bones — in 18 (50%) cases spreading on the skull base in 5 (13.8%). 57.6% skull fractures were observed in patients with mild TBI. Fractures in patients with mild TBI and concomitant intracranial injuries determines the duration of post-contusion symptoms (c2=4,9; p=0,026). CT is an obligatory examination at head trauma, also it allows to objectify the cause of the prolonged post-contusion syndrome at expert assessment of TBI severity.

Conclusions. 1. Closed scull fracture as a damage just of the bones in most cases can not be regarded as the immediate cause of death. 2. Linear scull fracture is a possible risk factor for intracranial lesions, but not a predictor of TBI severity. 3. Open penetrating head injury, multiple and comminuted fractures, skull base fractures, as well as pneumocephalus, liquorrhea indicate forming of life-threatening condition of the victim. 4. Linear fractures at mild TBI and associated intracranial injury cause prolonged existence of post-contusion symptoms.

Author Biographies

Eugene Pedachenko, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Nikolay Kadzhaya, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Andriy Huk, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Andrey Diadechko, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Dmytro Kuzmenko, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Andrii Boliukh, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Oleksandr Gotin, Romodanov Neurosurgery Institute, Kiev

NeuroTrauma Department

Oksana Skobska, Romodanov Neurosurgery Institute, Kiev

Otoneurology Unit

Oleg Robak, Romodanov Neurosurgery Institute, Kiev

Neuroradiology Department


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How to Cite

Pedachenko, E., Burchynskyi, V., Kadzhaya, N., Huk, A., Diadechko, A., Kuzmenko, D., Boliukh, A., Gotin, O., Skobska, O., & Robak, O. (2013). Skull fracture: an indicator of life-threatening injury or a predictor of intracranial injury?. Ukrainian Neurosurgical Journal, (4), 60–65.



Original articles