An Unusual Variant of a Growing Skull Fracture in an Adolescent

Çolak, Ahmėt; Akbasak, Aytac; Biliciler, Bülent; Erten, Serhat Fuat; Koçak, Ayhan

doi:10.1159/000028682

Cited by 12 publications

(5 citation statements)

References 11 publications

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“…In an extensive review of the relevant literature, we found that six cases of growing fractures of the orbital roof have previously been reported (table 1) [14, 15, 16, 17, 18, 19]. The patients with orbital roof growing fractures presented with diplopia, swollen eyelid, displaced globe and restricted eye movements after a latent silent period of varying length [14, 15, 16, 17, 18, 19]. Characteristically, none of the patients had a decline in visual acuity.…”

Section: Discussionmentioning

confidence: 99%

Growing Fractures of the Orbital Roof

Suri

Mahapatra

2002

Pediatr Neurosurg

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Growing fractures rarely arise in the skull base. Only six cases of orbital roof growing fractures were found in the relevant literature. We report two such cases. The first case was a 2-year-old girl who had progressive proptosis for 6 months following a mild head injury 1 year previously. The second case was a 9-year-old girl with a history of injury at the age of 3 months. She developed eye deviation and proptosis for 1 year. Computed tomography scan is excellent for demonstrating bony defects in the orbital roof, while magnetic resonance imaging is more sensitive in showing the intraorbital extension of a leptomeningeal cyst. Both patients were operated successfully and proptosis disappeared postoperatively. The exact pathophysiology of growing fractures is still debated in the literature, but a dural laceration along a fracture line is noted in all cases, and frontobasal brain injury seems to play an important role in the pathogenesis of the fracture growth. Growing fractures of the orbital roof should be suspected if ocular symptoms appear in a child who had sustained a head injury several months or years before.

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Section: Discussionmentioning

confidence: 99%

Growing Fractures of the Orbital Roof

Suri

Mahapatra

2002

Pediatr Neurosurg

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“…2,[9][10][11][12] Although the majority of patients present with complaints 2 to 12 months after the traumatic event, delay in presentation for 8 to 20 years has been reported. 2,13 In the authors' case, the patient presented 44 years after the initial injury. Because the clinical presentation can vary significantly, a classification scheme has been suggested to clarify the different pathologic processes.…”

Section: Discussionmentioning

confidence: 91%

Leptomeningeal Cyst of the Orbital Roof in an Adult: Case Report and Literature Review

Dublin

Strong

2008

Skull Base

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Objective: To present the case of a leptomeningeal cyst involving the orbital roof in an adult. Design: Case report and literature review. Setting: Tertiary referral center. Summary: A 47-year-old female with a remote history of a skull fracture at 3 years of age presented with increasing headaches and retro-orbital pain. A computed tomogram and magnetic resonance image revealed a leptomeningeal cyst of the orbital roof. Results: Only one previous leptomeningeal cyst of the orbital roof has been reported in an adult. Surgical excision of the lesion was performed and follow-up imaging 18 months after the operation revealed no evidence of recurrence. Conclusion: Although extremely rare, adult patients can develop growing skull fractures or leptomeningeal cysts of the orbital roof. Such lesions should be included in the differential diagnosis when a patient presents with orbital pain or exophthalmos and a history of head trauma as a child.

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“…On rare occasions, it has been observed in adolescence or adulthood [7, 8]. In most cases, children with simple 0,;0,-C59:413XX02CPSlinear skull fractures undergo an uneventful course of recovery.…”

Section: Discussionmentioning

confidence: 99%

“…This leptomeningeal cyst coupled with the outward force of a rapidly expanding infant brain augments the mechanical stress on the overlying bone and underlying cortex. CSF hydrodynamic features have also been implicated in the genesis of leptomeningeal cysts [7]. It has been hypothesized that the pulsatile force exerted on the ventricular wall encounters less resistance owing to the absence of dura and bone at the site of injury.…”

Section: Discussionmentioning

confidence: 99%

Early Management of Craniocerebral Injury with Avoidance of Post-Traumatic Leptomeningeal Cyst Formation

Sugiultzoglu

Souweidane²

2001

Pediatr Neurosurg

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Leptomeningeal cyst, or growing skull fracture, is a rare complication of pediatric head trauma. This entity is typically diagnosed several weeks or months following head trauma when an enlarging scalp mass is recognized. Progressive neurologic deficits (seizures, paresis) can accompany this process, which typically do not improve following conventional surgical treatment. Given that radiographic findings are highly predictive of which children are likely to develop a leptomeningeal cyst, we have adopted a policy of early management in an effort to avoid difficult surgical dissections and progressive neurologic sequelae seen with delayed intervention. The cases of two infants with skull fractures are used to illustrate our approach toward early management of post-traumatic leptomeningeal cysts.

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An Unusual Variant of a Growing Skull Fracture in an Adolescent

Cited by 12 publications

References 11 publications

Growing Fractures of the Orbital Roof

Growing Fractures of the Orbital Roof

Leptomeningeal Cyst of the Orbital Roof in an Adult: Case Report and Literature Review

Early Management of Craniocerebral Injury with Avoidance of Post-Traumatic Leptomeningeal Cyst Formation

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