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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0045-1811536
Case Report

Auto-Craniotomy in Head Injury: A Rare Case Report

Abhijit Acharya
1   Department of Neurosurgery, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
,
A. K. Mahapatra
1   Department of Neurosurgery, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
,
Souvagya Panigrahi
1   Department of Neurosurgery, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
,
Rama Chandra Deo
1   Department of Neurosurgery, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
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Abstract

Skull fractures are the well-known entity in patients with road traffic accidents (RTA) and falls from height. Skull fractures can be classified in view of site (basal or calvarial), pattern (linear, depressed, and diastasis), or type (simple or compound). Most patients commonly present with linear skull fractures. Elevated skull fractures (ESF) are a rare entity of skull fractures present in a few cases with fewer publications in literature. Most skull fractures occur due to a force acting in a perpendicular direction; however, elevated fractures occur due to force acting in a tangential direction on the calvarium. We present to you a 42-year-old male patient with a known case of psychiatric illness presented with a history of a fall from height followed by altered sensorium. On clinical evaluation and imaging, the patient has a large “skull cap” pattern of elevated calvarial fracture with a large extradural hematoma, subdural hematoma, diffuse cortical subarachnoid haemorrhage, and fronto-parietal contusion. He was operated on in emergency with a “S”-shaped incision with the removal of the fractured calvarial segment with lax duroplasty. In the post-operative period, the patient underwent tracheostomy and improved partially. He is on follow-up at present.

Keywords

skull cap fracture - head trauma - traumatic brain injuries - auto craniotomy


Publication History

Article published online:
27 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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