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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(03): 539-548
DOI: 10.4103/ajns.AJNS_183_18
Original Article

Growing skull fractures; pathogenesis and surgical outcome

G Singhal
Department of Neurosurgery, G B Pant Hospital, New Delhi
,
Sanjeev Atri
1   Department of Neurosurgery, NIMS Medical College and Hospital, Jaipur, Rajasthan
,
Sudheer Suggala
2   Assistant Professor of Neurosurgery, Doctor PSIMS and RF, Vijayawada, Andhra Pradesh
,
Dinesh Jaluka
3   Department of Neurosurgery, G Kar Medical College and Hospital, Kolkata
,
Shakti Singhal
4   Department of Anesthesia, Gajara Raja Medical College, Gwalior, Madhya Pradesh
,
A Shrivastava
Department of Neurosurgery, G B Pant Hospital, New Delhi
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Background: We performed a retrospective study of 67 patients and their data for radiological investigations by serial Xrays, computed tomography, magnetic resonance imaging, uniform surgical procedure of craniotomy. The results were analyzed to determine the natural course of the disease, anatomical changes at various intervals following trauma, and outcome of surgical procedure in terms of cranial reconstruction, seizures, and progress in neurological deficit. Results: Among 67 patients, 34 (50.74%) were male and 33 (49.26%) were female patients. About 86.67% of patients sustained the injury before the age of 3 years. Development of seizures in 28 patients (41.80%) is the most common symptom. In our study, 43.28% of patients (29 cases) had a combination of Type I and II of growing skull fracture. The dural defects confirmed in all cases were nearly twice (average 1.42) as large as the bone defects. All patients under the age of 3 years with diastatic skull fracture should be closely followed up and should be examined 2–3 months later to look for evidence of a growing skull fracture. Linear fractures and burst fractures in an infant with a scalp swelling must be corrected early to prevent a growing skull fracture. Conclusion: Early management can avoid difficult surgical dissection and progressive neurological sequelae seen with delayed intervention. Surgical correction results in the prevention of brain shift and increase in meningocerebral cicatrices. Meticulous surgery and vigilant postoperative care reduce the morbidity and mortality. In our opinion, the autologous material is the best choice because of its tissue compatibility, convenience, inexpensiveness, and rare rate of infection.

Key-words:

Duroplasty - growing skull fracture - linear skull fracture

Financial support and sponsorship

Nil.




Publication History

Received: 24 August 2018

Accepted: 26 January 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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