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

Abstract

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.

Severe brain injury with rupture of the superior sagittal sinus after vacuum extraction birth

“…Sporadic reports exist in the literature on leptomeningeal cysts caused by vacuum extraction, predominantly located over the anterior fontanelle. [4][5][6] These cysts may cause a growing fontanelle and require operative repair of the dural tear. Kau and colleagues 6 reported on a combination of a high frontal pseudomeningocele and traumatic brain lesion following vacuum extraction delivery.…”

Ventricular Reservoir Migration into the Lateral Ventricle through the Endoscopic Tract after Unsuccessful Third Ventriculostomy

“…We believe that the migration of a reservoir into the lateral ventricle is a complication unique to children, since a certain malleability of bone is necessary for it to occur. The growth of skull fractures, typically seen in children [12], indicates this malleability. This tendency of bone to open can be compensated for by the placement of a VP shunt [13], but the hole made in the bone can easily be affected by intracranial pressure and enlarged by unresolved hydrocephalus.…”