4 Cases of Treatment of Growing Skull Fracture

ABSTRACT

A fracture of the skull occurred during the infancy and childhood ordinarily heals without difficulty. Rarely, however, such a fracture enlarges progressively to form a permanent cranial defect with pulsating mass. Patients usually have a history of head trauma and skull fracture and show pulsating soft mass with underlying bony defect. Pulsation of the brain is transmitted through the cysts to the inner table of the skull, and erosion of the bone ordinarily occurs in a localized area overlying the cysts. Enlargement of skull fractures has been reported at least 4 months after the accident. The existence of a dura defect in this syndrome has been amply verified by operative and autopsy observation, and appears to be a requisite for enlargement of the fracture. Ideal is early diagnosis and preventive treatment before it develops into a growing skull fractrue. Repeated simple radiology and color doppler sonography are very useful for evaluation of growing skull fracture. Also an early and aggressive operation is strongly recommended in young children. We experienced 4 cases of the growing skull fracture, which were reconstructed with cranioplasty and duraplasty. Clinical findings and management of the growing skull fracture are discussed, a review of the relevant literature is presented.