Remote intracranial hemorrhage following surgery for giant orbitofrontal growing skull fracture: A lesson learnt

Area of Science:

• Pediatric Neurosurgery
• Traumatic Brain Injury
• Skull Fractures

Background:

• Growing skull fracture is a rare complication of pediatric head injury, often associated with dural tears.
• Early repair of the dural tear is often recommended for better outcomes in growing skull fractures.
• Surgical repair of large or tense growing skull fractures, particularly those involving the ventricles, carries significant risks.

Observation:

• A rare case of a 12-year-old girl with a large, tense growing skull fracture is presented.
• The patient developed remote intracranial hemorrhage following surgical repair of the fracture.
• The fracture involved communication with the ventricles, increasing surgical complexity and risk.

Findings:

• The study reports a rare instance of delayed intracranial hemorrhage after surgical intervention for a growing skull fracture.
• The pathogenesis of this remote hemorrhage following surgery for a large, tense growing skull fracture is discussed.
• The specific surgical challenges associated with growing skull fractures, especially those with ventricular communication, are highlighted.

Implications:

• This case underscores the potential for serious, life-threatening complications even after seemingly successful surgical repair of growing skull fractures.
• Understanding the pathogenesis of remote intracranial hemorrhage is crucial for preventing such adverse events.
• The findings suggest a need for refined surgical techniques and heightened vigilance during and after the management of complex pediatric growing skull fractures.