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"Growing fontanelle": a serious complication of difficult vacuum extraction
T A Huisman1, J Fischer, U V Willi
1Department of Magnetic Resonance, University Children's Hospital Zurich, Switzerland. thierry.huisman@dmr.usz.ch
Insights
A rare case of a growing fontanelle in an infant, caused by a leptomeningeal cyst from traumatic delivery, was successfully repaired. This highlights a unique presentation of growing skull fractures and dural tears.
Area of Science:
- Pediatric Neurosurgery
- Developmental Neurology
- Medical Imaging
Background:
- Growing skull fractures and leptomeningeal cysts are recognized pediatric conditions.
- These often result from birth trauma or genetic factors.
- Their occurrence necessitates careful evaluation and management.
Observation:
- A rare case of a growing fontanelle, a soft spot on an infant's skull, is presented.
- This specific instance was attributed to a leptomeningeal cyst.
- The cyst developed following a difficult birth involving vacuum extraction.
Findings:
- Surgical repair of the leptomeningeal cyst was performed.
- A tear in the dura mater, the brain's protective covering, was identified at the fontanelle's edge.
- Imaging studies provided crucial insights into the cyst's formation and the associated dural defect.
Implications:
- This case expands the known spectrum of growing skull abnormalities.
- It underscores the importance of considering dural integrity in fontanelle abnormalities.
- Early diagnosis and surgical intervention are crucial for favorable outcomes in such rare pediatric conditions.
Abstract:
Growing skull fractures in combination with leptomeningeal cysts are well known in childhood. A rare case of a growing fontanelle due to a leptomeningeal cyst is presented. The cyst occurred due to a traumatic delivery with vacuum extraction. Operative repair of the cyst revealed a dural tear at the border of the fontanelle. The imaging findings are discussed.