Q. CT scan of my brother showed small frontal fracture. Is emergency surgery required?

Answered by
Dr. Rahul Patil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 04, 2021

Hello doctor,

My brother had a bike accident. The ER doctor recommends that we need a CT scan. We now have the results of the CT scan, and we consulted a Neurologist online about it. He suggests asking a Neurosurgeon because of the small fracture seen in his CT scan. Is his small fracture critical? How urgent is it? Do we need to go to the emergency now?



Welcome to icliniq.com.

I have seen the CT scan (attachment removed to protect patient identity).

Your brother has a head injury for which he needs hospitalization. CT scan shows a small EDH of thickness 5 mm, which also needs observation in the hospital. It also shows internal compounding fracture of the left frontal sinus with pneumocephalus and multiple hemosinuses. So your brother has a high risk of brain infection and CSF (cerebrospinal fluid) leak. This also needs a very close observation.

Internal compound fracture of frontal sinus is an indication for surgical repair at the earliest. However, conservative management trial can be given.

I would advise you to take your brother to a hospital and admit him to proper treatment under a neurosurgeon. Do it on an emergency basis.

Thank you doctor,

His accident took place four days ago. The CT scan is done the next day. As of now, his symptoms are mild. From the day of the accident, he experienced dizziness and difficulty sleeping. But yesterday and today, his dizziness and difficulty sleeping are gone. He can sleep better now. He did not vomit, no severe headache, no seizure, loss of consciousness, and other symptoms. He just had dizziness and difficulty sleeping, but it is better. Is it fair to wait for the symptoms to arise before going to the emergency?



Welcome back to icliniq.com.

Look for running nose or ear, loss of consciousness, vomiting, convulsion, increase in dizziness, increase in headache, neck rigidity, pain in neck movements, fever, disorientation, or clouding of consciousness.

If any one of these arises, then take him to the hospital immediately. However, I will still recommend you to show him to a neurosurgeon in the nearby hospital so that he could see your brother in person and advice accordingly.

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