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[Growing cranial fractures in infancy (author's transl)]
Insights
Growing cranial fractures in infancy, often linked to early trauma, can cause significant brain alterations. Surgical intervention frequently reveals dural defects and leptomeningeal cysts, impacting neurological development.
Area of Science:
- Pediatric Neurosurgery
- Neuropathology
Context:
- Presents seventeen cases of growing cranial fractures in infancy.
- Seventy percent of cases involved a traumatic episode before one year of age.
Purpose:
- To analyze the clinical presentation, surgical findings, and long-term outcomes of growing cranial fractures in infants.
- To investigate associated neuropathological changes and neurological sequelae.
Summary:
- Thirteen patients underwent surgery, revealing dural defects, leptomeningeal alterations, and cerebral cortex changes.
- Leptomeningeal cysts were present in 70% of cases, and all studied patients showed ventricular system alterations.
- Follow-up data for fifteen cases (5 months to 11 years) allowed analysis of electroencephalographic changes and neurological deficits.
Impact:
- Highlights the complex neuropathology associated with growing cranial fractures in infants.
- Underscores the importance of early diagnosis and surgical intervention for managing these complex pediatric neurosurgical cases.
- Provides insights into the long-term neurological and electroencephalographic evolution, including an uncommon clinical presentation.
Abstract:
Seventeen cases of growing cranial fractures in infancy are presented, eleven males and six females. Seventy per cent of the cases suffered a traumatic episode before one year of life. Thirteen of the total group experienced surgical intervention in which a completely defective duramater and alterations of the leptomeninges and the subsequent cerebral cortex were encountered. Leptomeningeal cysts were found in nine patients or 70 per cent of the cases. Ventricular system revealed alterations in all cases that were studied by means of neumoencephalography or computerized axial tomography. Evolution of 15 of the cases was follow up for a period of time which varied between five months to eleven years of age. An analysis of electroencephalographical alterations and neurological sequelae is made. An uncommon form of clinical-electroencephalographic evolution is described in one of the cases.