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Internal open brain injury or cranial burst fracture: report of 8 cases

Chao-hua Yang1, Qiang Li, Guo-ping Li

  • 1Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, PR China. yangchaohua999@gmail.com

Pediatric Neurosurgery
|November 27, 2009
PubMed

Insights

Internal open brain injury (IOBI) in children involves brain extrusion through an intact scalp. Surgical intervention, including craniotomy and dural repair, leads to improved neurological status and no posttraumatic epilepsy.

Area of Science:

  • Pediatric neurosurgery
  • Traumatic brain injury research
  • Skull fracture classification

Background:

  • Internal open brain injury (IOBI) is a rare pediatric head trauma.
  • Characterized by dural laceration and cerebral extrusion with an intact scalp.
  • Understanding IOBI's unique presentation is crucial for timely intervention.

Observation:

  • Eight pediatric patients (2-5 years) with IOBI were analyzed.
  • Clinical signs include scalp swelling, linear skull fracture, and brain contusion.
  • Intraoperative findings consistently showed acute cerebral extrusion and lacerated dura mater.

Findings:

  • Surgical treatment resulted in general neurological improvement for all patients.
  • Follow-up CT scans confirmed surgical outcomes.
  • No posttraumatic epilepsy developed during 4- to 20-month follow-up.

Implications:

  • IOBI requires prompt surgical management, including craniotomy, debridement, and dural repair.
  • This approach appears effective in preventing long-term complications like epilepsy.
  • Highlights the importance of recognizing and treating this specific pediatric head injury pattern.
Abstract

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