Prevention of growing skull fractures

Report of 2 cases

View More View Less
  • Department of Pediatric Neurosurgery, University of Tennessee Health Science Center, Semmes-Murphey Clinic, Memphis, Tennessee
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

The author describes 2 cases of children with growing skull fractures (GSFs). Surgical exploration of the widened fracture shortly after the head injury failed to reveal a dural tear because the neuroimaging studies (MR images, CT scans, and skull radiographs) had not been accurately interpreted, thereby allowing the development of a GSF at the site of the actual dural injury. In both cases, the dural and bony defect and the leptomeningeal cyst were successfully repaired.

To prevent GSFs associated with progressive neurological deficit, seizure, ventricular porencephaly, and encephalomalacia, the author surgically explores wide skull fractures in young children with head injury whose MR images demonstrate brain herniation through the dura mater. The importance of a brief delay in surgical exploration is emphasized to allow cerebral edema to resolve and the patient's condition to become medically stabilized.

Abbreviation used in this paper: GSF = growing skull fracture.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address correspondence to: Robert A. Sanford, M.D., Department of Pediatric Neurosurgery, University of Tennessee Health Science Center, 6325 Humphrey's Boulevard, Memphis, Tennesee 38120. email: Robert.Sanford@stjude.org.
  • 1

    Britz GW, , Kim DK, & Mayberg MR: Traumatic leptomeningeal cyst in an adult: a case report and review of the literature. Surg Neurol 50:465469, 1998

    • Search Google Scholar
    • Export Citation
  • 2

    Donahue DJ, , Sanford RA, , Muhlbauer MS, & Chadduck WM: Cranial burst fracture in infants: acute recognition and management. Childs Nerv Syst 11:692697, 1995

    • Search Google Scholar
    • Export Citation
  • 3

    Ellis TS, , Vezina LG, & Donahue DJ: Acute identification of cranial burst fracture: comparison between CT and MR imaging findings. AJNR Am J Neuroradiol 21:795801, 2000

    • Search Google Scholar
    • Export Citation
  • 4

    Ersahin Y, & Gülmen V: Growing skull fractures: a clinical study of 41 patients. Acta Neurochir (Wien) 140:519, 1998. (Letter)

  • 5

    Ersahin Y, , Gülmen V, , Palali I, & Mutluer S: Growing skull fractures (craniocerebral erosion). Neurosurg Rev 23:139144, 2000

  • 6

    Goldstein F, , Sakoda T, , Kepes JJ, , Kavidson K, & Brackett CE: Enlarging skull fractures: an experimental study. J Neurosurg 27:541550, 1967

    • Search Google Scholar
    • Export Citation
  • 7

    Gupta SK, , Reddy NM, , Khosla VK, , Mathuriya SN, , Shama BS, & Pathak A, : Growing skull fractures: a clinical study of 41 patients. Acta Neurochir (Wien) 139:928932, 1997

    • Search Google Scholar
    • Export Citation
  • 8

    Husson B, , Pariente D, , Tammam S, & Zerah M: The value of MRI in the early diagnosis of growing skull fracture. Pediatr Radiol 26:744747, 1996

    • Search Google Scholar
    • Export Citation
  • 9

    Iyer SG, , Saxena P, & Kumhar GD: Growing skull fractures. Indian Pediatr 40:11941196, 2003

  • 10

    Johnson DL, & Helman T: Enlarging skull fractures in children. Childs Nerv Syst 11:265268, 1995

  • 11

    Kingsley D, , Till K, & Hoare R: Growing fractures of the skull. J Neurol Neurosurg Psychiatry 41:312318, 1978

  • 12

    Kutlay M, , Demircan N, , Akin ON, & Basekim C: Untreated growing cranial fractures detected in late stage. Neurosurgery 43:7277, 1998

  • 13

    Muhonen MG, , Piper JG, & Menezes AH: Pathogenesis and treatment of growing skull fractures. Surg Neurol 43:367373, 1995

  • 14

    Naim-Ur-Rahman , Jamjoom Z, , Jamjoom A, & Murshid WR: Growing skull fractures: classification and management. Br J Neurosurg 8:667679, 1994

    • Search Google Scholar
    • Export Citation
  • 15

    Nalls G, , Lightfoot J, , Lee A, & Blackwell L: Leptomeningeal cyst: nonenhanced and enhanced computed tomography findings. Am J Emerg Med 8:3435, 1990

    • Search Google Scholar
    • Export Citation
  • 16

    Onizuka K, , Momma F, , Ohara S, & Ohyama T: Emerging symptoms of growing skull fracture after secondary trauma in an adult—case report. Neurol Med Chir (Tokyo) 34:807809, 1994

    • Search Google Scholar
    • Export Citation
  • 17

    Pezzotta S, , Silvani V, , Gaetani P, , Spanu G, & Rondini G: Growing skull fractures of childhood. Case report and review of 132 cases. J Neurosurg Sci 29:129135, 1985

    • Search Google Scholar
    • Export Citation
  • 18

    Rinehart GC, & Pittman T: Growing skull fractures: strategies for repair and reconstruction. J Craniofac Surg 9:6572, 1998

  • 19

    Roy S, , Sarkar C, , Tandon PN, & Banerji AK: Cranio-cerebral erosion (growing fracture of the skull in children). Part I. Pathology. Acta Neurochir (Wien) 87:112118, 1987

    • Search Google Scholar
    • Export Citation
  • 20

    Scarfo GB, , Mariottini A, , Tomaccini D, & Palma L: Growing skull fractures: progressive evolution of brain damage and effectiveness of surgical treatment. Childs Nerv Syst 5:163 167, 1989

    • Search Google Scholar
    • Export Citation
  • 21

    Sugiultzoglu MK, & Souweidane MM: Early management of craniocerebral injury with avoidance of post-traumatic leptomeningeal cyst formation. Report of two cases. Pediatr Neurosurg 35:329333, 2001

    • Search Google Scholar
    • Export Citation
  • 22

    Tandon PN, , Banerji AK, , Bhatia R, & Goulatia RK: Cranio-cerebral erosion (growing fracture of the skull in children). Part II. Clinical and radiological observations. Acta Neurochir (Wien) 88:19, 1987

    • Search Google Scholar
    • Export Citation
  • 23

    Weinberg JS, , LeRoux PD, , Panasci D, & Weiner HL: Adult growing skull fracture mimicking a skull tumor. Acta Neurochir (Wien) 141:545546, 1999

    • Search Google Scholar
    • Export Citation
  • 24

    Ziyal IM, , Aydin Y, , Turkmen CS, , Salas E, , Kaya AR, & Ozveren F: The natural history of late diagnosed or untreated growing skull fractures: report on two cases. Acta Neurochir (Wien) 140:651654, 1998

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 561 208 5
Full Text Views 134 6 0
PDF Downloads 77 7 0
EPUB Downloads 0 0 0