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Linear skull fractures in infants may initially appear to grow but can heal on their own. This "pseudogrowing skull fracture" phenomenon requires careful distinction from true growing fractures needing surgery.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Orthopedics
- Pediatric Radiology
Background:
- Growing skull fractures (GSFs) are a rare but serious complication of linear skull fractures in infants.
- GSFs are characterized by progressive enlargement of the fracture and underlying dura mater, often leading to neurological deficits.
- Early surgical intervention is typically recommended for GSFs to prevent adverse outcomes.
Observation:
- Two infant cases presented with linear parietal bone fractures.
- Initial radiographic assessment suggested fracture line enlargement, mimicking GSF.
- However, subsequent imaging revealed spontaneous healing of the fractures.
Findings:
- The observed phenomenon was termed "pseudogrowing skull fracture" to differentiate it from true GSFs.
- This suggests that not all enlarging fractures in infants represent GSFs requiring surgery.
- Spontaneous healing is a possible outcome even after initial apparent growth.
Implications:
- Accurate diagnosis is crucial to avoid unnecessary surgical intervention for pseudogrowing skull fractures.
- Radiologists and clinicians should consider spontaneous healing as a potential course for some infant skull fractures.
- Further research may clarify the specific criteria to distinguish between true and pseudogrowing skull fractures.
Abstract:
We report two cases in which linear fractures of the parietal bone in infants healed spontaneously after initial enlargement suggested growth of the fracture line. We suggest the term "pseudogrowing skull fracture" to indicate this phenomenon. Growing skull fractures are best managed by early surgical correction. It is, therefore, important to recognize that some fractures may heal after an initial period of growth.