Journal of Maxillofacial and Oral Surgery

, Volume 17, Issue 4, pp 531–537 | Cite as

Brain Injuries and Facial Fractures: A Prospective Study of Incidence of Head Injury Associated with Maxillofacial Trauma

  • Udupikrishna M. JoshiEmail author
  • Shashank Ramdurg
  • Saujanya Saikar
  • Satishkumar Patil
  • Kundan Shah
Original Article



Presence of head injuries in patients with maxillofacial trauma is a lifethreatening condition. Prompt determination of head injury in these patients is crucial for improving patient survival and recovery. Hence, the need to know about the incidence of head injuries associated with maxillofacial trauma becomes an important aspect.

Materials and Methods

A total of 100 patients were included in the study. Patient with head injuries associated with maxillofacial fractures was accounted to determine the incidence and pattern of head injuries accompanying maxillofacial trauma. They were evaluated for epidemiological demographic and clinical characteristics.


The present study had 91% predominance of male patients with age ranging from 1 to 75 years. 91% cases were as a result of RTA. The most frequent maxillofacial injury represented was the fractured mandible. The incidence of head injuries associated with maxillofacial trauma was 67 %. Among all the patterns of head injuries, concussion was the most common head injury associated with maxillofacial trauma.


In our study, the risk of head injury increased significantly as the Glasgow Coma Scale score decreased and with increase in the number of facial fractures. There was association between head injury and maxillofacial trauma.


Facial fractures Incidence Head injury 


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Luce EA, Tubb TD, Moore AM (1979) Review of 1,000 major facial fractures and associated injuries. Plast Reconstr Surg 63:26–30PubMedCrossRefGoogle Scholar
  2. 2.
    Lee KF, Wagner LK, Lee YE, Suh JH, Lee SR (1987) The impact-absorbing effects of facial fractures in closed-head injuries: An analysis of 210 patients. J Neurosurg 66(4):542–547PubMedCrossRefGoogle Scholar
  3. 3.
    Follmar KE, Debruijn M, Baccarani A, Bruno AD, Mukundan S, Erdmann D, Marcus J (2007) Concomitant injuries in patients with panfacial fractures. J Trauma 63:831–835PubMedCrossRefGoogle Scholar
  4. 4.
    Lim LH, Lam LK, Moore MH, Trott JA, David DJ (1993) Associated injuries in facial fractures: review of 839 patients. Br J Plast Surg 46:635–638PubMedCrossRefGoogle Scholar
  5. 5.
    Alvi A, Doherty T, Lewen G (2003) Facial fractures and concomitant injuries in trauma patients. Laryngoscope 113:102–106PubMedCrossRefGoogle Scholar
  6. 6.
    Mulligan RP, Friedman JA, Mahabir RC (2010) A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures. J Trauma 68:587–592PubMedCrossRefGoogle Scholar
  7. 7.
    Sigaroudi AK, Saberi BV, Chabok SY (2012) The relationship between mid-face fractures and brain injuries. J Dent Shiraz Univ Med Sci 13(1):18–22Google Scholar
  8. 8.
    Davidoff G, Jakubowski M, Thomas D, Alpert M (1988) The spectrum of closed-head injuries in facial trauma victims: incidence and impact. Ann Emerg Med 17:6–9PubMedCrossRefGoogle Scholar
  9. 9.
    Keenan HT, Brundage SI, Thompson DC, Maier RV, Rivara FP (1999) Does the face protect the brain? A case control study of traumatic brain injury and facial fractures. Arch Surg 134:14–17PubMedCrossRefGoogle Scholar
  10. 10.
    Martin RC II, Spain DA, Richardson JD (2002) Do facial fractures protect the brain or are they markers for severe head injury? Am Surg 68(5):477–481PubMedGoogle Scholar
  11. 11.
    Kraus JF, Rice TM, Peek-Asa C, McArthur DL (2003) Facial trauma and the risk of intracranial injury in motorcycle riders. Ann Emerg Med 41:18–26PubMedCrossRefGoogle Scholar
  12. 12.
    Rajandram RK, Syed Omar SN, Rashdi MF, Jabar A, Nazimi M (2014) Maxillofacial injuries and traumatic brain injury—a pilot study. Dent Traumatol 30:128–132PubMedCrossRefGoogle Scholar
  13. 13.
    Gwyn PP, Carraway JH, Horton CE, Adamson JE, Mladick RA (1971) Facial fractures-associated injuries and complications. Plast Reconstr Surg 47:225–230PubMedCrossRefGoogle Scholar
  14. 14.
    Işik D, Gönüllü H, Karadaş S, KOÇAK ÖF, KESKİN S, Garca MF, EŞEOĞLU M (2012) Presence of accompanying head injury in patients with maxillofacial trauma. Ulus Travma Acil Cerrahi Derg 18(3):200–206PubMedCrossRefGoogle Scholar
  15. 15.
    Kloss F, Laimer K, Hohlrieder M, Ulmer H, Hackl W, Benzer A, Schmutzhard E, Gassner R (2008) Traumatic intracranial haemorrhage in conscious patients with facial fractures—a review of 1959 cases. J CranioMaxillofac Surg 36(7):372–377PubMedCrossRefGoogle Scholar
  16. 16.
    Fonseca RJ, Walker RV, Norman BJ (2005) Oral and maxillofacial trauma, 3rd edn. Elsevier, USA, pp 211–213Google Scholar
  17. 17.
    Haug RH, Savage JD, Likavec MJ, Conforti PJ (1992) A review of 100 closed head injuries associated with facial fractures. J Oral Maxillofac Surg 50:218–222PubMedCrossRefGoogle Scholar
  18. 18.
    Rahman SA, Chandrasala S (2014) When to suspect head injury or cervical spine injury in maxillofacial trauma? Dent Res J 11(3):336Google Scholar
  19. 19.
    Grant AL, Ranger A, Young GB, Yazdani A (2012) Incidence of major and minor brain injuries in facial fractures. J Craniofac Surg 23(5):1324–1328PubMedCrossRefGoogle Scholar
  20. 20.
    Zandi M, Seyed Hoseini SR (2013) The relationship between head injury and facial trauma: a case–control study. Oral Maxillofac Surg 17:201–207PubMedCrossRefGoogle Scholar
  21. 21.
    Pappachan B, Alexender M (2006) Correlating facial fractures and cranial injuries. J Oral Maxillofac Surg 64(7):1023–1029PubMedCrossRefGoogle Scholar
  22. 22.
    Haug RH, Prather J, Indresano AT (1990) An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg 48:926–932PubMedCrossRefGoogle Scholar
  23. 23.
    Chang CJ, Chen YR, Noordhoff MS, Chang CN (1994) Maxillary involvement in central craniofacial fractures with associated head injuries. J Trauma 37:807–811PubMedCrossRefGoogle Scholar
  24. 24.
    Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet. 2(7872):81–84PubMedCrossRefGoogle Scholar
  25. 25.
    Telfer MR, Jones GM, Shepherd JP (1991) Trends in the aetiology of maxillofacial fractures in the United Kingdom (1977–1987). Br J Oral Maxillofac Surg 29:250–255PubMedCrossRefGoogle Scholar
  26. 26.
    Hutchison IL, Magennis P, Shepherd JP, Brown AE (1998) The BAOMS United Kingdom survey of facial injuries part 1: aetiology and the association with alcohol consumption. Br J Oral Maxillofac Surg 36:3–13PubMedCrossRefGoogle Scholar
  27. 27.
    Buchanan J, Colquhoun A, Friedlander L (2005) Maxillofacial fractures at Waikato Hospital, New Zealand: 1989 to 2000. N Z Med J 118:1217Google Scholar
  28. 28.
    Mason PN (1990) Facial injuries. In: McCarthy JG (ed) Plastic surgery. Philadelphia, Saunders, pp 868–872Google Scholar
  29. 29.
    Al Ahmed HE, Jaber MA, Abu Fana SH, Karas M (2004) The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:166–170PubMedCrossRefGoogle Scholar
  30. 30.
    Hassan NA, El Kelany RS, Emara AM, Amer M (2010) Pattern of craniofacial injuries in patients admitted to Tanta University Hospital-Egypt. J Forensic Leg Med 17(1):26–32PubMedCrossRefGoogle Scholar
  31. 31.
    Arabion HR, Tabrizi R, Aliabadi E, Gholami M, Zarei K (2014) A retrospective analysis of maxillofacial trauma in Shiraz, Iran: a 6-year-study of 768 patients (2004–2010). J Dent Shiraz Univ Med Sci 15(1):15–21Google Scholar
  32. 32.
    Fasola AO, Nyako EA, Obiechina AE, Arotiba JT (2003) Trends in the characteristics of maxillofacial fractures in Nigeria. J Oral Maxillofac Surg 61:1140–1143PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2018

Authors and Affiliations

  • Udupikrishna M. Joshi
    • 1
    Email author
  • Shashank Ramdurg
    • 2
  • Saujanya Saikar
    • 1
  • Satishkumar Patil
    • 1
  • Kundan Shah
    • 1
  1. 1.Department of Oral and Maxillofacial SurgeryHkes’s S. Nijalingappa Institute of Dental Sciences and ResearchGulbargaIndia
  2. 2.Department of NeurosurgeryMahadevappa Rampure Medical CollegeGulbargaIndia

Personalised recommendations