title: Elevated skull fractures in pediatric age group: report of two cases.
abstract: Elevated fractures of the skull, which are rarely reported in the literature, are always compound, have maximal neurological deficits at presentation and have been reported only in adults. We report two cases of elevated skull fractures in the pediatric age group, one of which was a simple elevated fracture and presented with delayed neurological deterioration. The etiologies were a fall in first case and an animal attack (bear maul) in the second case as reported for the first time. One of the cases presented with delayed onset of left focal hemispheric signs. The first case underwent debridement, duraplasty and reduction of fracture whereas in the second case the bone flap was not replaced immediately because of gross contamination. Both patients had an excellent outcome. Elevated skull fractures are not uncommon in the pediatric age group. Compound elevated skull fractures should be managed early as open depressed fractures. Reduction of a simple elevated fracture presenting with neurological deficits not explained by any other lesion can result in a good outcome.
authors.affiliation: SKIMS, Department of Neurosurgery, Srinager/ J&K, India. sarabjitchhiber@gmai.com
authors.forename: Sarbjit Singh
authors.initials: SS
authors.lastname: Chhiber
authors.forename: Mohd Afzal
authors.initials: MA
authors.lastname: Wani
authors.forename: Altaf Rehman
authors.initials: AR
authors.lastname: Kirmani
authors.forename: Altaf Umar
authors.initials: AU
authors.lastname: Ramzan
authors.forename: Nayil Khursheed
authors.initials: NK
authors.lastname: Malik
authors.forename: Abrar Ahmad
authors.initials: AA
authors.lastname: Wani
authors.forename: Abdul Rashid
authors.initials: AR
authors.lastname: Bhat
authors.forename: Anil
authors.initials: A
authors.lastname: Dhar
authors.forename: Basharat
authors.initials: B
authors.lastname: Kanth
mesh_terms: D000058:Accidental Falls; D000818:Animals; D001037:Aphasia / Q000209:etiology; D002648:Child; D003646:Debridement; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D010291:Paresis / Q000209:etiology; D019651:Plastic Surgery Procedures; D012887:Skull Fractures / Q000209:etiology* / Q000601:surgery; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D001503:Ursidae