Cranio-cerebral erosion (growing fracture of the skull in children)

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.

Section: Introductionmentioning

confidence: 99%

Growing Fractures of the Orbital Roof

Suri

Mahapatra

2002

“…Characteristic features of this entity include a skull fracture with an underlying dural tear and progressive enlargement of the fracture with time to produce a cranial defect [1, 4, 5, 6]. The incidence of growing skull fractures is only 0.6% of the cases in large series [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Growing Skull Fracture of the Orbital Roof

Koç¹,

Kurtsoy²,

Oktem³

et al. 1999

Growing skull fractures are rare complications of head trauma and very rarely arise in the skull base. The clinical and radiological finding and treatment of a growing fracture of the orbital roof in a 5-year-old boy are reported, and the relevant literature is reviewed. The clinical picture was eyelid swelling. Computed tomography (CT) scan was excellent for demonstrating the bony defect in the orbital roof. Frontobasal brain injury seems to play an important role in the pathogenesis of the fracture growth. Growing skull fracture of the orbital roof should be considered in the differential diagnosis in cases of persistent ocular symptoms. Craniotomy with excision of gliotic brain and granulation tissue, dural repair and cranioplasty is the treatment of choice.

“…Standard X-rays are typi-cal in most cases with a linear fracture, mainly parietal [14], with separation of its edges by >4 mm. associated with an overlying soft tissue shadow.…”

Section: Discussionmentioning

confidence: 99%

Rapid Evolution of a Growing Skull Fracture after Vacuum Extraction in Case of Fetal Hydrocephalus

Hes¹,

Jong²,

Geuze³

et al. 1997

Vacuum extraction in nonprogressive labor is relatively safe. Only a few major complications have been mentioned. This article describes the rapid development of a growing skull fracture associated with a porencephalic cyst and parenchymal brain damage after a difficult vacuum extraction in a patient with congenital hydrocephalus and a thoracic meningomyelocele. The diagnostic and therapeutic management is discussed.