Growing Skull Fracture of the Orbital Roof

Abstract

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.

Long-Term Results of Orbital Roof Repair with Titanium Mesh in a Case of Traumatic Intraorbital Encephalocele: A Case Report and Review of Literature

“…2,5,6,22 In a series of 58 orbital roof fractures, associated cranial lesions were reported as frontal contusions (43%), epidural hematomas (17%), traumatic subarachnoid hemorrhage (14%), and encephalocele (9%). 23 As the associated cranial lesions, frontobasal contusion and encephalocele were present in our case.…”

Growing Fractures of the Orbital Roof

“…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.…”

Pseudomeningocele With Orbital Extension as a Complication of Fronto-Orbital Advancement and Remodeling in Craniosynostosis

“…This duration is similar to reported cases of growing skull fractures posttrauma. 2,8,10,17 All of our patients presented with orbital pseudomeningocele, with enlarging bony defect similar to growing skull fracture. Disruption of the orbital roof can result in pulsatile periorbtal swelling and proptosis 2,8,10 ptosis, diplopia, displaced globe, and restricted eye movements 18,19 -all features seen in the patients in our series.…”

“…9,10,14 Meticulous water tight dural repair with fibrin glue reinforcement þ/À pericranium or other dural reconstruction is required, and a bone graft to support the repair and isolate the orbit from the cranial cavity is necessary. 9,11,13,17,22,24 In our series of 6 patients, dural repair at FOAR was performed using either nonabsorbable or absorbable sutures as it was believed that nonabsorbable sutures improved the durability of the repair. However, this was disproven as all patients where a dural defect was noted, required a duraplasty at the time of pseudomeningocele repair.…”