title: The relationship between head injury and facial trauma: a case-control study.
abstract: BACKGROUND
  In spite of anatomic proximity of the facial skeleton and cranium, there is paucity of information in the literature regarding the relationship between head injuries and facial trauma. The objective of our investigation was to evaluate the pattern of head injuries in patients with maxillofacial trauma, and to study their relationship.
  
  
  METHODS
  We evaluated 2,692 patients with maxillofacial trauma admitted to the Besat hospital, Hamedan, Iran between 2007 and 2010. Patients with associated head injury (302 cases; study group) were compared with those without head injury (2,390 cases; control group).
  
  
  RESULTS
  In our cohort, the rate of head injuries associated with facial bone fractures was 23.3 %. The most common associated head injury was concussion, followed by cerebral contusion and skull fractures. In the unadjusted analysis, motorcycle and car accidents were significantly more frequent in the study group, while stumbling, sports injuries, and work-related injuries were significantly more common in the control group (p < 0.001). Except for Lefort III fractures which was not significantly different between groups, all facial fractures occurred more frequently in the study group (p < 0.001). Logistic regression analysis demonstrated that motorcycle accidents (211-fold), car accidents (139-fold), violence (69-fold), falls (66-fold), frontal sinus fractures (84.5-fold), and Lefort II fractures (27-fold) were the strongest predictors of head injuries.
  
  
  CONCLUSIONS
  Present study revealed that fracture of facial bones, especially bones that are in anatomic proximity to the cranium and need a high magnitude of trauma energy to be fractured, was marker for an increased risk of head injuries.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hamedan University of Medical Sciences, Iran. zandi88m@yahoo.com
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zandi
authors.forename: Seyed Rohallah
authors.initials: SR
authors.lastname: Seyed Hoseini
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001265:Athletic Injuries / Q000453:epidemiology; D001930:Brain Injuries / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005147:Facial Bones / Q000293:injuries; D005260:Female; D005626:Frontal Sinus / Q000293:injuries; D006801:Humans; D007492:Iran; D008297:Male; D008446:Maxillofacial Injuries / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D060051:Occupational Injuries / Q000453:epidemiology; D011446:Prospective Studies; D012887:Skull Fractures / Q000453:epidemiology / Q000209:etiology; D013223:Statistics as Topic; D014754:Violence / Q000706:statistics & numerical data; D055815:Young Adult