Isolated Skull Fractures in Children: A Systematic Review and Meta-Analysis.

Sunday, May 5, 2024

2:46 PM – 2:48 PM CT

Location: Booth 745 Neuro Spotlight

Presenting Author(s)

Lucca B. Palavani

Medical Student
Max Planck University Center

Co-Author(s)

Raphael Bertani, MD

Neurosurgeon
Department of Neurosurgery, University of São Paulo
S�o Paulo, SP, BR
Filipi Andre�o

Medical Student
Federal University of Rio de Janeiro
Rio de Janeiro, RJ, BR
SB

Savio Batista, n/a

Medical student
Federal University of Rio de Janeiro, United States
Marcio Yuri Ferreira, MD

Research Collaborator
Program in Global Surgery and Social Change - Harvard Medical School. Postgraduate Program in Translational Surgery of Federal University of São Paulo, Brazil
Leonardo Oliveira (he/him/his)

Medical Student
Department of Neurosurgery, State University of Ponta Grossa, Paraná, Brazil
Ponta Grossa, PR, BR
WS

Wellingson Silva Paiva, M.D., Ph.D.

Neurosurgeon
University of São Paulo
Sao Paulo, United States
GV

Gabriel Verly, n/a

Medical Student
Federal University of Rio de Janeiro, United States

Disclosure(s):

Filipi Fim Andreao: No financial relationships to disclose

Marcio Yuri Ferreira, MD: No financial relationships to disclose

Lucca B. Palavani: No financial relationships to disclose

Introduction: The impact of traumatic brain injury (TBI) on the pediatric population is profound. Isolated skull fracture plays an important role in pediatric TBI, mainly due to its own unique characteristics. The aim of this study is to unveil the state of the evidence concerning acute neurosurgical intervention, hospitalizations after injury, and neuroimaging in isolated skull fractures (ISF).

Methods: This systematic review was conducted in accordance with PRISMA guidelines. PubMed, Cochrane, Web of Science, and Embase were searched for papers until April 2023. Inclusion criteria were ISF cases diagnosed via Computed Tomography, and studies reporting 4 or more patients. The ROBINS-I scale was used to measure the risk of bias in this study.

Results: A total of 10,350 skull fractures from 25 studies were included, of which 7,228 were ISF. For the need for acute neurosurgical intervention, the meta-analysis showed a risk of 0% (95%CI: 0%-0%). Considering hospitalization after injury, the calculated risk was 78% (95% CI: 66%-89%), and the neuroimaging intervention revealed a rate of 7% (95% CI: 0%-15%). No deaths were reported in any of the 25 studies.

Conclusion : Out of 7,228 children with ISF, an almost negligible number required immediate neurosurgical interventions, yet a significant 74% were hospitalized for up to 72 hours. Notably, the mortality was zero, and repeat neuroimaging was uncommon. This research is crucial in shedding light on the outcomes and implications of pediatric TBIs concerning ISFs