[Depression fractures of the skull in newborn infants. Treatment with vacuum extractor]

Depressed skull fracture in newborns, usually called "ping-pong" lesion, is rare. The fractures may interfere with the function and growth of the brain and may establish an epileptogenic focus. Therefore early elevation is usually necessary. Traditionally, these lesions have been considered to be indication for neurosurgical elevation. During recent years, non-surgical elevation by means of breast pump or vacuum extractor have been reported. This procedure is technically feasible and less traumatic to the infant, and should be attempted before considering operative intervention. If the fractures are combined with bone fragments in the cerebral tissue or if epidural or subdural hematomas exist, surgical treatment is indicated. A case is described in which a depression fracture of the skull was successfully reduced by vacuum extractor.