Abstract
Background
Delayed swelling after skull fractures is an uncommon complication following head trauma in children. Classically, growing skull fractures typically present in patients under 3 years of age with progressive subcutaneous fluid collections, or occasionally with neurologic symptoms. We present the case of a healthy 2-year-old boy with a lytic “punched-out” frontal skull lesion. The child presented 2 months after a minor forehead injury for which no medical attention was sought.
Methods
The skull defect had no associated leptomeningeal cyst or brain herniation. Imaging and presentation were thought to be consistent with eosinophilic granuloma. Histologic findings demonstrated a healing skull fracture.
Results
Cranioplasty was performed, and the patient had an uncomplicated postoperative course.
Conclusions
In this report, we describe our experience with this atypical presentation of a healing skull fracture mimicking a typical eosinophilic granuloma.
Similar content being viewed by others
References
Lende RA, Erickson TC (1961) Growing skull fractures of childhood. J Neurosurg 18:479–489
Arseni C, Simionescu MD (1966) Growing skull fractures of childhood. A particular form of posttraumatic encephalopathy. Acta Neurochir (Wien) 15:159–172
de P Djientcheu V, Njamnshi AK, Ongolo-Zogo P, Kobela M, Rilliet B, Essomba A, Sosso MA (2006) Growing skull fractures. Childs Nerv Syst 22:721–725
Tandon PN, Banerji AK, Bhatia R, Goulatia RK (1987) Cranio-cerebral erosion (growing fracture of the skull in children). Part II. Clinical and radiological observations. Acta Neurochir (Wien) 88:1–9
Ersahin Y, Gülmen V, Palali I, Mutluer S (2000) Growing skull fractures (craniocerebral erosion). Neurosurg Rev 23:139–144
Pezzotta S, Silvani V, Gaetani P, Spanu G, Rondini G (1985) Growing skull fractures of childhood. Case report and review of 132 cases. J Neurosurg Sci 29:129–135
Kobayashi TK, Ueda M, Nishino T, Bamba M, Echigo T, Oka H, Hino A, Fuse I, Fujimoto M, Katsumori T, Kaneko C (2007) Langerhans cell histiocytosis of the skull on cytologic squash preparations. Diagn Cytopathol 35:154–157
Kurosu A, Fujii T, Ono G (2004) Post-traumatic leptomeningeal cyst mimicking a skull tumour in an adult. Br J Neurosurg 18:62–64
Weinberg JS, LeRoux PD, Panasci D, Weiner HL (1999) Adult growing skull fracture mimicking a skull tumor. Acta Neurochir (Wien) 141:545–546
Taveras JM, Ransohoff J (1953) Leptomeningeal cysts of the brain following trauma with erosion of the skull; a study of seven cases treated by surgery. J Neurosurg 10:233–241
Ito H, Miwa T, Onodra Y (1977) Growing skull fracture of childhood with reference to the importance of the brain injury and its pathogenetic consideration. Childs Brain 3:116–126
Roy S, Sarkar C, Tandon PN, Banerji AK (1987) Cranio-cerebral erosion (growing fracture of the skull in children). Part I. Pathology. Acta Neurochir (Wien) 87:112–118
Muhonen MG, Piper JG, Menezes AH (1995) Pathogenesis and treatment of growing skull fractures. Surg Neurol 43:367–373
D'Ambrosio N, Soohoo S, Warshall C, Johnson A, Karimi S (2008) Craniofacial and intracranial manifestations of langerhans cell histiocytosis: report of findings in 100 patients. AJR Am J Roentgenol 191:589–597
Fox JD, Knighton RS (1956) Diagnosis and treatment of eosinophilic granuloma of skull. J Am Med Assoc 162:1294–1297
Arseni C, Dănăilă L, Constantinescu A (1977) Cranial eosinophilic granuloma. Neurochirurgia (Stuttg) 20:189–199
Baker GS, Fisher RG (1948) Eosinophilic granuloma of the skull; report of four cases, with 5-year follow-up. Surg Clin N Am 28:1057–1070
Rawlings CE, Wilkins RH (1984) Solitary eosinophilic granuloma of the skull. Neurosurgery 15:155–161
Mut M, Cataltepe O, Bakar B, Cila A, Akalan N (2004) Eosinophilic granuloma of the skull associated with epidural haematoma: a case report and review of the literature. Childs Nerv Syst 20:765–769
Yoon SH, Park SH (2008) A study of 77 cases of surgically excised scalp and skull masses in pediatric patients. Childs Nerv Syst 24:459–465
Gibson SE, Prayson RA (2007) Primary skull lesions in the pediatric population: a 25-year experience. Arch Pathol Lab Med 131:761–766
De Angulo G, Nair S, Lee V, Khatib Z, Ragheb J, Sandberg DI (2013) Nonoperative management of solitary eosinophilic granulomas of the calvaria. J Neurosurg Pediatr 12:1–5
Oliveira M, Steinbok P, Wu J, Heran N, Cochrane D (2003) Spontaneous resolution of calvarial eosinophilic granuloma in children. Pediatr Neurosurg 38:247–252
Sekhar LN, Scarff TB (1980) Pseudogrowth in skull fractures of childhood. Neurosurgery 6:285–289
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hollon, T., McKeever, P.E., Garton, H.J.L. et al. Skull fracture mimicking eosinophilic granuloma. Childs Nerv Syst 31, 1171–1174 (2015). https://doi.org/10.1007/s00381-015-2676-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-015-2676-8