Pathogenesis and treatment of growing skull fractures

Muhonen, Michael G.; Piper, John G.; Menezes, Arnold H.

doi:10.1016/0090-3019(95)80066-p

Cited by 119 publications

(110 citation statements)

References 15 publications

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“…12,14 This phenomenon occurs almost exclusively in children, resulting from pulsatile pressure of the growing brain through a fracture line associated with an unrecognized dural laceration, driving arachnoid membrane and CSF into and, in many cases, through the diploic space of the skull. A similar process may rarely follow a craniotomy in which a persistent CSF fistula leads to bony erosion and gradual defect expansion.…”

Section: Discussionmentioning

confidence: 99%

Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management

Gandhoke¹,

Hauptman²,

Salvetti³

et al. 2015

PED

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The authors report a unique case of a transosseous CSF fistula that was detected more than 10 years after treatment of a symptomatic Chiari I malformation. This lesion initially presented as an intraosseous cystic lesion involving the C-2 vertebra, which was found to communicate freely with the subarachnoid space through a tiny dural opening. Surgical management involved hemilaminectomy and repair of the dural defect followed by reinforcement of the bony defect with demineralized bone matrix. Following closure of the fistula, symptoms of elevated intracranial pressure developed, necessitating a ventriculoperitoneal shunt for CSF diversion.

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Section: Discussionmentioning

confidence: 99%

Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management

Gandhoke¹,

Hauptman²,

Salvetti³

et al. 2015

PED

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“…Growing skull fractures are rare complications of head trauma, occuring almost exclusively in infants and children under the age of 3 [1, 2]and rarely in adult life [3]. 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].…”

Section: Introductionmentioning

confidence: 99%

Growing Skull Fracture of the Orbital Roof

Koç¹,

Kurtsoy²,

Oktem³

et al. 1999

Pediatr Neurosurg

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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.

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Section: Discussionmentioning

confidence: 99%

“…The resultant pressure cone may promote brain herniation through the defect; this combined with normal growth of the brain and skull contributes to continued enlargement of the fracture [29]. In the majority of cases, fracture resolution relies on exposing the edges of the dura and creating a water-tight dural closure to normalize lines of intracranial pressure [29]. In the case presented here, we did not attempt to create a water-tight dural seal or repair the calvarial defect, rather relying on SIS as a dural substitute and polypropylene mesh and the temporalis musculature to provide a protective scaffold over the defect.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of a Chronic Brain Abscess and Growing Skull Fracture in a Dog

Hodshon

Narak

Craig

et al. 2015

Case Reports in Veterinary Medicine

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A 2-year-old female spayed Miniature Dachshund was presented for seizures and right prosencephalic signs. A multiloculated, ring-enhancing mass in the right cerebrum associated with dilation of the right lateral ventricle and brain herniation was seen on magnetic resonance imaging. An irregular calvarial defect with smoothly scalloped edges was seen overlying the mass on computed tomography. The mass was removed via craniectomy and was diagnosed as a chronic brain abscess caused by Peptostreptococcus anaerobius. The patient was maintained on antibiotics for 12 weeks. Follow-up MRI performed 14 weeks after surgery confirmed complete removal of the abscess as well as a contrast-enhancing collection of extra-axial material consistent with a chronic subdural hematoma. The neurologic abnormalities, including seizures, have improved in the 44 months since surgery. Brain abscesses in dogs can have an insidious clinical course prior to causing serious neurologic deterioration. Ventricular entrapment by an intracranial mass can contribute to acute neurologic decline. If surgically accessible, outcome following removal of a brain abscess can be excellent; aerobic and anaerobic bacterial culture should be performed in these cases. Subdural hematoma can occur following removal of a large intracranial mass. Growing skull fractures can occur in dogs but may not require specific surgical considerations.

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Pathogenesis and treatment of growing skull fractures

Cited by 119 publications

References 15 publications

Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management

Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management

Growing Skull Fracture of the Orbital Roof

Surgical Treatment of a Chronic Brain Abscess and Growing Skull Fracture in a Dog

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