title: Early surgery does not seem to be a pivotal criterion to improve prognosis in patients with frontal depressed skull fractures.
abstract: BACKGROUND
  There has been much debate about the ideal timing of surgery of frontal depressed skull fractures (DSF). In this paper, we assess whether timing of surgery may have influenced outcome.
  
  
  METHODS
  Retrospective cohort of 40 consecutive patients with frontal DSF who underwent surgical treatment over a 36-month period. The patients were divided into early surgery group (ESG) which were operated within 24 h and delayed surgery group (DSG).
  
  
  RESULTS
  The population comprised 39 (97.50%) men and the mean age was 27.9 years (range, 2-81 yr). There was no difference of age (P = 0.53), gender male (P = 1.00), presence of focal lesion on head CT (P = 0.89), hypotension (P = 0.28), and hypoxia (P = 0.15). Mean Glasgow Coma Scale (GCS) was significantly lower in patients of ESG than DSG (8.75 and 11.7, resp., P = 0.02). There was no difference between the groups in relation to death (P = 0.13), unfavourable outcome (P = 0.41), late posttraumatic epilepsy (P = 0.64), and smell-and-taste disturbances (P = 1.00). Only one patient (3.5%) evolved meningitis during follow-up.
  
  
  CONCLUSIONS
  We found no difference between the ESG and DSG in respect to death, unfavourable outcome, LPE, and STD.
authors.affiliation: Division of Neurosurgery, University of São Paulo Medical School, Rua Oscar Freire 1380, 05409-010 Sao Paulo, SP, Brazil.
authors.forename: Iuri Santana
authors.identifier: 0000-0002-8561-9069
authors.initials: IS
authors.lastname: Neville
authors.affiliation: Division of Neurosurgery, University of São Paulo Medical School, Rua Oscar Freire 1380, 05409-010 Sao Paulo, SP, Brazil.
authors.forename: Robson Luis
authors.identifier: 0000-0003-2391-7519
authors.initials: RL
authors.lastname: Amorim
authors.affiliation: Division of Neurosurgery, University of São Paulo Medical School, Rua Oscar Freire 1380, 05409-010 Sao Paulo, SP, Brazil.
authors.forename: Wellingson Silva
authors.identifier: 0000-0002-5165-7040
authors.initials: WS
authors.lastname: Paiva
authors.affiliation: Division of Neurosurgery, University of São Paulo Medical School, Rua Oscar Freire 1380, 05409-010 Sao Paulo, SP, Brazil.
authors.forename: Felipe Hada
authors.identifier: 0000-0003-3091-6266
authors.initials: FH
authors.lastname: Sanders
authors.affiliation: Division of Neurosurgery, University of São Paulo Medical School, Rua Oscar Freire 1380, 05409-010 Sao Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.identifier: 0000-0002-7974-6045
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Division of Neurosurgery, University of São Paulo Medical School, Rua Oscar Freire 1380, 05409-010 Sao Paulo, SP, Brazil.
authors.forename: Almir Ferreira
authors.identifier: 0000-0003-1799-0250
authors.initials: AF
authors.lastname: de Andrade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006257:Head / Q000000981:diagnostic imaging; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D020204:Skull Fracture, Depressed / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult