[Growing skull fracture].
BACKGROUND
Growing skull fracture (GSF) is a rare complication of cranial trauma in children younger than 3 years. It is characterised by the presence of a dural defect due to which herniation of the brain tissue can develop, with cystic transformation and resulting cerebral damage.


METHODS
A 5-month-old baby girl presented at the emergency department following a fall from the staircase. Upon examination she showed a left parietal subgaleal haematoma and right-sided hemiparesis. MRI examination of the brain showed a skull fracture and dural defect with progressive herniation of the brain tissue. Neurosurgical reconstruction was carried out.


CONCLUSIONS
GSF is a rare complication of cranial trauma in young children as a result of rupture of the dura and separating fracture edges. This can lead to cerebral damage and early recognition is important. GSF needs to be considered in children younger than 3 years with a (pulsating) subgaleal haematoma. The diagnosis is made by MRI scan of the brain and neurosurgical treatment consists of watertight closure of the dura combined with skull reconstruction.
VU Medisch Centrum, Neurochirurgisch Centrum Amsterdam, Amsterdam, the Netherlands. hedy.folkersma@vumc.nl
Hedy
H
Folkersma
Sander
S
Idema
Mirko L A
ML
Bal
Fonnet E
FE
Bleeker
Nicole I
NI
Wolf
W Peter
WP
Vandertop
D000058:Accidental Falls; D001930:Brain Injuries / Q000175:diagnosis / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D012887:Skull Fractures / Q000175:diagnosis* / Q000601:surgery*; D013997:Time Factors