title: Growing skull fractures: a clinical study of 41 patients.
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.
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Gupta
authors.forename: N M
authors.initials: NM
authors.lastname: Reddy
authors.forename: V K
authors.initials: VK
authors.lastname: Khosla
authors.forename: S N
authors.initials: SN
authors.lastname: Mathuriya
authors.forename: B S
authors.initials: BS
authors.lastname: Shama
authors.forename: A
authors.initials: A
authors.lastname: Pathak
authors.forename: M K
authors.initials: MK
authors.lastname: Tewari
authors.forename: V K
authors.initials: VK
authors.lastname: Kak
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D016489:Head Injuries, Closed / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt