A Case of Growing Skull Fracture with Appearance of the Sinking Skin Flap Syndrome

Abstract

1262growing skull fracture (GSF) is a progressive enlarging diastatic fracture, which occurs as a rare complication of head trauma almost exclusively in infants and children.1 Brain contusion, porencephalic cyst formation and alterations of cerebrospinal fluid circulation generally accompany the dural defect. The incidence of GSF ranges from 0.05 to 1.6% of pediatric skull fractures, and the patients generally present with scalp swelling and neurological deficits. 2,3 It is known that the scalp overlying the defect can appear flat or sunken.2,4 However, orthostatic sinking of the scalp over the GSF has not been reported. A Case of Growing Skull Fracture withAppearance of the Sinking Skin Flap Syndrome A AB BS S T TR RA AC CT T A growing skull fracture is a late complication of a traumatic linear skull fracture. Untreated growing skull fractures can be associated with headache and progressive neurological deficits. In this case report, an unusual growing skull fracture mimicking sinking skin flap syndrome is presented. An 11-year-old girl, who had had a linear skull fracture 6 years previously, presented with headache, progressive left hemiparesis and right parietal scalp swelling on supine position. The scalp overlying the bone defect was sinking on upright position like the sinking skin flap syndrome. The growing skull fracture, revealed on the plain X-ray and computed tomography, was treated by duraplasty and cranioplasty with methylmetacrilate. The symptom of headache resolved and her walk improved after the treatment.

Contralateral Subdural Effusion Occurring in Growing Skull Fracture: A Case Report

“…It has been reported to be seen in 0.05-1.6% of skull fractures. Half of the cases are under the age of 1 year, and 90% are under the age of 3 years (2)(3)(4)(5)9). Although there are some authors who say they cannot be seen over the age of 8 years(5), cases diagnosed in adulthood are rare (4,5).…”