Internal open brain injury or cranial burst fracture: report of 8 cases.
OBJECTIVE
We report a special type of skull fracture in children - internal open brain injury (IOBI). We summarize its clinical characteristics and propose a treatment strategy based on our experience.


METHODS
Eight patients between 2 and 5 years old were identified to have IOBI. Preoperative computed tomography (CT) scanning was performed in each case and magnetic resonance imaging was conducted when available. All patients were treated surgically. The clinical data were retrospectively analyzed and each patient underwent follow-up CT scanning.


RESULTS
IOBI has no special clinical manifestations other than scalp swelling, linear skull fracture and local brain contusion. Acute cerebral extrusion outside the calvaria and lacerated dura mater were seen during operation in each patient. Each patient's neurological status generally improved after surgery. No patient developed posttraumatic epilepsy during the 4- to 20-month follow-up period.


CONCLUSIONS
IOBI is a type of head trauma in which dura mater is lacerated and the cerebrum is extruded outside the calvaria but the scalp remains intact. Craniotomy with evacuation of devitalized brain tissue and dural repair should be performed.
Yang
Chao-hua
CH
Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, PR China. yangchaohua999@gmail.com
Li
Qiang
Q
Li
Guo-ping
GP
You
Chao
C
D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy; D004388:Dura Mater / Q000293:injuries / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications; D012887:Skull Fractures / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed