title: Linear undisplaced fracture of temporoparietal bone acting as spontaneous early decompressive craniotomy in a neonate.
abstract: Decompressive craniotomy (DC) is used to treat intracranial hypertension associated with traumatic brain injury. Early DC is associated with better outcomes. We present a neonate with a history of fall with computed tomography scan showing a large frontoparietal contusion and associated parietal and temporal bone fracture. This acted as a spontaneous DC causing bony segment to separate due to which the edematous brain could be accommodated. Despite the presence of a large contusion, the child was neurologically intact and medically managed. The neonate presented with a posttraumatic leptomeningeal cyst 2 months later, which had to be repaired surgically. We discuss how a linear undisplaced fracture acts as spontaneous DC and the role of early DC in improving outcomes.
authors.affiliation: Department of Neurosurgery, Topiwala National Medical College, and Bai Yamunabai Laxman Charitable Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Vankipuram
authors.affiliation: Department of Neurosurgery, Topiwala National Medical College, and Bai Yamunabai Laxman Charitable Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Srikant
authors.initials: S
authors.lastname: Balasubramanium
authors.affiliation: Department of Neurosurgery, Topiwala National Medical College, and Bai Yamunabai Laxman Charitable Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Devendra K
authors.initials: DK
authors.lastname: Tyagi
authors.affiliation: Department of Neurosurgery, Topiwala National Medical College, and Bai Yamunabai Laxman Charitable Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: H V
authors.initials: HV
authors.lastname: Savant
keywords: Decompressive craniotomy; intracranial hypertension; linear skull fracture; pediatric traumatic brain injury