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Usefulness of color Doppler sonography in a growing skull fracture: case report
H Yoshioka1, K Sakoda, H Kohno
1Department of Neurosurgery, Mazda Motor Corporation, Mazda Hospital, Japan.
Insights
A pulsating protrusion in an infant indicated a growing skull fracture. Color Doppler sonography diagnosed this condition, revealing cerebral herniation and guiding successful surgical treatment.
Area of Science:
- Pediatric Neurosurgery
- Diagnostic Imaging
Background:
- Growing skull fracture is a rare complication of pediatric head trauma.
- It can lead to neurological deficits if not promptly diagnosed and treated.
Observation:
- An 11-month-old infant presented with altered consciousness and hemiparesis post-head injury.
- A pulsating mass developed over the fracture site one month later.
Findings:
- Color Doppler sonography identified cerebral herniation through the bony defect.
- Intracranial arterial flow was detected in the extracranial space, confirming the diagnosis.
- Sonography proved crucial for evaluating intracranial status and hemodynamics.
Implications:
- This case highlights the diagnostic utility of Color Doppler sonography for growing skull fractures.
- Early sonographic diagnosis facilitated timely surgical intervention, preventing long-term motor deficits.
Abstract:
A case of an 11-month-old infant with a growing skull fracture is described. The patient was admitted with disturbance of consciousness and left hemiparesis after a severe head injury. A pulsating protrusion appeared over the fracture line 1 month later. Color Doppler sonography revealed cerebral herniation and cystic lesion via the bony defect, together with an intracranial arterial flow pattern detected in the extracranial space. Color Doppler sonography was very useful in the diagnosis of growing skull fracture and in the evaluation of the intracranial state, including hemodynamics in this case. Successful surgical treatment was performed on the basis of sonographic data and the patient was discharged 3 months later without motor deficits.