Neglected growing skull fractures in childhood: Three case reports

Abstract

Growing skull fractures are rare complications of head injury, affecting almost exclusively young children. This disease is characterized by the progression of a skull fracture with an underlying dural tear, leading to large cranial vault defects and parenchymal porencephalic damages. This report on three cases with a radiological follow-up depicts the difficulty in the management of neglected cases. Three young patients (two months, two years and six years old) were managed for growing skull fracture in our department since 2001. Even if the three patients were diagnosed early, the therapeutic management was complex because of a long delay due to several reasons. While a cranioplasty and dural repair were performed in all patients, one required a shunt procedure for a large leptomeningeal cyst associated with a unilateral hydrocephalus. The clinical and radiological features are reviewed, as well as pathophysiological hypotheses and therapeutic principles.

Keywords

Leptomeningeal cyst - growing skull fracture - head trauma - encephalomalacia - cranioplasty - head injury sequelae