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Indian Journal of Neurotrauma 2016; 13(01): 007-010
DOI: 10.1055/s-0036-1583266
Original Article
Neurotrauma Society of India

Management Strategies for Growing Skull Fractures: A Single-Center Experience

Vernon Velho
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Hrushikesh U. Kharosekar
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Harish Naik
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Shonali Valsangkar
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Pravin Survashe
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
› Author Affiliations
Further Information

Publication History

19 November 2015

17 March 2015

Publication Date:
19 April 2016 (online)

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Abstract

Introduction Growing skull fractures are a rare but significant complication of pediatric head trauma, occurring mostly in children. Growing skull fractures are associated with a breach in the dura underlying the fracture line and may exceed the line of fracture making the management difficult. A delay in diagnosis exacerbates this disease increasing morbidity.

Materials and Methods A retrospective analysis of 36 patients who were operated for growing skull fracture between August 2005 and August 2015 in our institute was done.

Results Most common age group at presentation was 1 to 6 months and fall from height was the most common etiology. All patients underwent surgical repair; 23 required only duraplasty whereas cranioplasty with dural repair was done at the same time in 13 patients. Osteomesh, titanium mesh, and autologous bone chips were used for cranioplasty. All patients who presented to us with scalp swelling had complete resolution of swelling, whereas of the 7 patient who had neurologic deficit, 5 improved postoperatively (71%). Good clinical outcome was obtained in all patients.

Conclusion Herniation of the brain matter and underlying dural tear, which can extend beyond the bony defect makes management challenging in growing skull fracture.

Keywords

growing skull fracture - Osteomesh - titanium mesh - duraplasty - children
 

  • References

  • 1 Liu XS, You C, Lu M, Liu JG. Growing skull fracture stages and treatment strategy. J Neurosurg Pediatr 2012; 9 (6) 670-675
    CrossrefPubMedGoogle Scholar
  • 2 Diyora B, Nayak N, Kamble H, Kukreja S, Gupte G, Sharma A. Surgical treatment and results in growing skull fracture. Neurol India 2011; 59 (3) 424-428
    CrossrefPubMedGoogle Scholar
  • 3 Sener RN. Growing skull fracture in a patient with cerebral hemiatrophy. Pediatr Radiol 1995; 25 (1) 64-65
    CrossrefPubMedGoogle Scholar
  • 4 Pia HW, Tonnis W. [Growing skull fractures of childhood]. Zentralbl Neurochir 1953; 13 (1) 1-23
    PubMedGoogle Scholar
  • 5 Howship J. Practical Observations in Surgery and Morbid Anatomy. London, UK: A Strahan; 1816
    PubMedGoogle Scholar
  • 6 Rahimizadeh A, Haddadian K. Bilateral traumatic leptomeningeal cysts. Neurosurgery 1986; 18 (3) 386-387
    PubMedGoogle Scholar
  • 7 Lende RA, Erickson TC. Growing skull fractures of childhood. J Neurosurg 1961; 18: 479-489
    CrossrefPubMedGoogle Scholar