title: Internal open brain injury or cranial burst fracture: report of 8 cases.
abstract: 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.
authors: Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, PR China. yangchaohua999@gmail.com
authors: Chao-hua
authors: CH
authors: Yang
authors: Qiang
authors: Q
authors: Li
authors: Guo-ping
authors: GP
authors: Li
authors: Chao
authors: C
authors: You
mesh_terms: 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