Related Experiment Videos
[Growing skull fracture: a case report]
H Ishibashi1, H Matsuno, Y Yamashita
1Department of Neurosurgery, Iizuka Hospital.
Insights
A pediatric growing skull fracture, a rare complication of head trauma, involves a skull defect with brain herniation. Surgical repair with cranioplasty and dural plasty is essential for treatment.
Area of Science:
- Pediatric Neurosurgery
- Traumatic Brain Injury
- Cranial Surgery
Background:
- Growing skull fracture is a rare complication of pediatric head trauma.
- It is characterized by progressive enlargement of a linear skull fracture.
- This condition can lead to brain herniation and neurological deficits.
Observation:
- An 18-day-old infant sustained a head injury resulting in a linear parietal skull fracture and subarachnoid hemorrhage.
- The fracture and associated fluid collection enlarged over time, with imaging revealing brain herniation through the defect.
Findings:
- Magnetic resonance imaging (MRI) and computed tomography (CT) were essential in diagnosing the growing skull fracture, demonstrating the relationship between the fracture, torn dura, enlarged ventricle, and contused brain.
- The patient underwent cranioplasty with dural plasty for the growing skull fracture.
Implications:
- Cranioplasty with dural repair is an effective treatment for growing skull fractures, leading to an uneventful postoperative recovery.
- Advanced imaging techniques, including MRI and CT, are vital for the accurate diagnosis and management planning of growing skull fractures.
Abstract:
An 18-day-old male baby who had fallen from his mothers arms and hit his head on the floor was admitted to our hospital. On admission, the patient was crying, but no weakness was noted in the extremities. A small fluctuant protrusion was visible in the right parietal region. The plain skull X-ray film revealed a wide linear fracture in the parietal bone. Computed tomography (CT) showed swelling of the right hemisphere and a traumatic subarachnoid hemorrhage. At 41 days old, the subcutaneous fluid collection had increased in volume and the width of the linear skull fracture was also enlarged as shown on the X-ray film. CT and magnetic resonance imaging (MRI) revealed a large cyst herniating through the wide parietal bone defect. There was also an enlarged right lateral ventricle and a torn dural margin in the brain. The cranioplasty with dural plasty was performed on the 43rd day of ago under the diagnosis of growing skull fracture of the right parietal bone. The postoperative course was uneventful, without seizure or weakness. In order to diagnose growing skull fracture, especially to show the relationship between the fracture, torn dura matter, the ventricle and the contused brain, MRI was very helpful combined with CT and plain skull X-rays. Cranioplasty with dural repair was considered the essential procedure for the treatment of such growing skull fractures.