Growing Skull Fracture in the Primary Motor Cortex in a 50-day-old Child: A Case Report

Growing skull fracture (GSF) is a rare complication of skull fracture in children. We report a case of GSF, also known as leptomeningeal cyst with significant damage in the motor cortex in a 50-day-old child, but the motor function was preserved. A 50-day-old male baby visited our hospital after trauma in the left side of the head. His level of consciousness and motor function were normal. Brain computed tomography (CT) scan revealed gapped skull fracture of the left parietal lobe with underlying contusion and subdural hemorrhage. During hospitalization, bulging in the left parietal scalp had progressed, and follow-up magnetic resonance imaging revealed increased skull defect with enlarged leptomeningeal cyst at the left motor cortex. Cranioplasty and duroplasty were performed. Intraoperatively, a dura tear, brain tissue herniation and fluid collection around the motor cortex were observed. One-year follow-up CT revealed cystic encephalomalacia in the left motor cortex. During the 30-month follow-up, nearly normal gross motor function was observed except for few fine motor impairments. We report a case of GSF with significant damage on the motor cortex in an early infant, but with the preserved motor function during the postoperative developmental process.