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Growing skull fractures (craniocerebral erosion)
Y Ersahin1, V Gülmen, I Palali
1Division of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey. ersahin@med.ege.edu.tr
Neurosurgical Review
|November 22, 2000
Summary
Growing skull fractures, rare but serious pediatric injuries, often present with scalp masses. Early identification via CT or MRI is crucial for timely intervention and improved outcomes.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Traumatology
- Skull Base Surgery
Background:
- Growing skull fractures (GSF) are a rare complication of pediatric head trauma, with an incidence ranging from 0.05% to 1.6%.
- These fractures occur in infants and young children, often resulting from falls, and can lead to significant neurological deficits if not managed appropriately.
Purpose of the Study:
- To retrospectively review the clinical presentation, management, and outcomes of pediatric patients diagnosed with growing skull fractures.
- To identify key diagnostic features and prognostic indicators for GSF in the pediatric population.
Main Methods:
- Retrospective review of 22 pediatric patients diagnosed with growing skull fractures.
- Analysis of patient demographics, injury mechanisms, clinical signs and symptoms, imaging findings (CT/MRI), surgical interventions, and neurological outcomes.
Main Results:
- Falling was the most common cause of injury in 15 boys and 7 girls (mean age 12.4 months).
- Scalp mass (17 patients) and dural defect (greater than bony defect in most cases) were frequent findings.
- Gliotic tissue was universally present; 16 patients had good neurological outcomes, while six had minor deficits.
Conclusions:
- Growing skull fractures require close follow-up, especially in children under 3 with diastatic fractures.
- CT or MRI evidence of a persistent diastatic fracture with brain herniation strongly suggests GSF, necessitating prompt neurosurgical evaluation and management.