Related Experiment Videos
Growing skull fractures: a clinical study of 41 patients
S K Gupta1, N M Reddy, V K Khosla
1Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Growing skull fractures, a rare complication of pediatric head trauma, require surgical repair. This study reviews 41 cases, highlighting common causes, locations, and surgical outcomes.
Area of Science:
- Pediatric Neurosurgery
- Trauma Surgery
- Pediatric Neurology
Background:
- Growing skull fractures are rare complications of head injury in children under three.
- This retrospective review analyzed 41 patients over 20 years.
Purpose of the Study:
- To review the clinical presentation, management, and outcomes of growing skull fractures.
- To identify common etiologies, fracture locations, and associated intracranial pathologies.
Main Methods:
- Retrospective review of 41 patients diagnosed with growing skull fractures.
- Analysis of patient demographics, injury mechanisms, fracture sites, imaging findings, surgical interventions, and complications.
Main Results:
- Most patients (80.5%) were under 5 years old.
- Common causes included falls (93%) and road traffic accidents.
- Parietal or frontoparietal locations were most frequent (56%); CT scans revealed porencephalic cysts or hydrocephalus in some.
- Surgical interventions included ventriculo-peritoneal shunts, duroplasty, and duro- and cranioplasty using various materials.
- Complications included mortality (3 patients), CSF leaks (3), and wound infections (6).
Conclusions:
- Growing skull fractures in children necessitate prompt diagnosis and surgical management.
- Effective surgical strategies can improve outcomes, but potential complications must be managed proactively.
Abstract:
Growing skull fractures are rare complications of head injury, occurring almost exclusively in infants and children under the age of three. A retrospective review at our Institute yielded 41 patients with this entity over a period of 20 years (1975-1995). The age at presentation ranged from less than 1 year to 62 years, with 33 (80.5%) patients being less than 5 years of age. The cause of injury was either a fall from a height (93%) or a road traffic accident. The most common location of a growing skull fracture was either parietal or frontoparietal (56%). One patient had a posterior fossa growing skull fracture. CT scan was performed in 19 patients which demonstrated an underlying porencephalic cyst, hydrocephalus or a cyst communicating with the ventricle. In 5 children, a ventriculo-peritoneal shunt alone was performed. Twenty four patients underwent a duro- and cranioplasty while a duroplasty alone was performed in 8 patients. The material used for cranioplasty included acrylic, wire mesh, steel plates or autologous bone. Three patients died, one due to an anaesthetic complication and two as a result of postoperative meningitis. Post-operative CSF leaks occurred in 3 patients, which were managed by a lumbar drain. Six patients had local wound infection.