Growing skull fracture in childhood. A recurrent case treated by shunt operation

The authors report a case of growing skull fracture in which watertight dural closure was difficult at the first operation because a dural defect extended deep into the middle fossa. Bulging of the cranioplasty site occurred 2 months later. In the second operation, instead of reinforcement of the dura mater, a shunt operation was performed to decompress the cyst and the locally dilated ventricle, which was thought to contribute to the intracranial expansive forces. The bulging did not recur. In the treatment of growing skull fracture, a shunt operation should be considered when watertight closure of the dural defect cannot be achieved and in case of recurrence after failure of the first operation.