Abstract
Large skull fractures are conventionally followed radiographically until healing occurs. Fractures which enlarge or remain unhealed are commonly termed “leptomeningeal cysts” or “growing skull fractures”. This study of ten children with this injury and a review of the literature shows that a true leptomeningeal cyst is seldom present and that skull fractures do not “grow”. Moreover, careful history-taking and physical examination will correctly identify all enlarging or unhealed skull fractures of childhood without the need for plain radiographs or computed tomography of the skull.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Billroth T (1862) Ein Fall von Meningocele spuria cum fistula ventriculi cerebri. Arch Klin Chir 3:398–442
Bruce DA (1982) Special considerations of the pediatric age group. In: Cooper PR (ed) Head injury. Williams & Wilkins, Baltimore, pp 315–325
Bruce DA, Schut L, Sutton LN (1985) Pediatric head injury. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 1600–1604
Conner PS (1884) Traumatic cephalhydrocele: with a report of two cases. Am J Med Sci 88:103–110
Dyke CG (1937) The roentgen ray diagnosis and treatment of diseases of the skull and intracranial contents. In: Palmer WW (ed) Nelson's loose-leaf medicine, vol 6. Nelson, New York, 6:185–214
Eisenberg HM, Briner RP (1989) Late complications of head injury. In: McLaurin RL, Schut L, Venes JL, Epstein F (eds) Pediatric neurosurgery. Saunders, Philadelphia, pp 290–297
Godlee RJ (1885) Two cases of simple fracture of the skull in infants followed by the development of a pulsating subcutaneous tumour. Trans Pathol Soc Lond 36:313–324
Goldstein F, Sakoda T, Keped JJ, Davidson K, Brackett CE (1967) Enlarging skull fractures. An experimental study. J Neurosurg 27:541–550
Gruber FH (1969) Posttraumatic leptomeningeal cysts. Am J Roentgenol Rad Ther Nucl Med 105:305–307
Kashiwagi S, Abiko S, Aoki H (1986) Growing skull fracture in childhood: a recurrent case treated by shunt operation. Surg Neurol 26:63–66
Keener EB (1959) An experimental study of reactions of the dura mater to wounding and loss of substance. J Neurosurg 16:424–427
Kingsley D, Till D, Hoare R (1978) Growing fractures of the skull. J Neurol Neurosurg Psychiatry 41:312–318
Lende RA (1974) Enlarging skull fractures of childhood. Neuroradiology 7:119–124
Lende RA, Erickson TC (1961) Growing skull fractures of childhood. J Neurosurg 18:479–489
Locatelli D, Messina AL, Bonfanti N, Pazzotta S, Gajno TM (1989) Growing fractures: an unusual complication of head injuries in pediatric patients. Neurochirurgia 32:101–104
Lye RH, Occleshaw JV, Dutton J (1981) Growing fracture of the skull and the role of computerized tomography. J Neurosurg 55:470–472
Matson DD (1969) Neurosurgery of infancy and childhood. Thomas, Springfield, Ill
Pancoast HK, Pendergrass EP, Schaeffer JP (1940) The head and neck in roentgen diagnosis. Thomas, Springfield, Ill
Pendergrass EP, Schaeffer JP, Hodes PJ (1956) The head and neck in roentgen diagnosis. Thomas, Springfield, Ill
Penfield W, Erickson TC (1941) Epilepsy and cerebral localization. A study of the mechanism, treatment and prevention of epileptic seizures. Thomas, Springfield, Ill
Pia HW (1954) Zur Pathogenese and Frühbehandlung der “wachsenden Schädelfraktur des Kindesalters”. Dtsch Z Nervenheilkd 172:1–11
Ramamurthi B, Kalyanaraman S (1970) Rationale for surgery in growing fractures of the skull. J Neurosurg 32:427–430
Roy S, Sarkar C, Tandon PN, Banerji AK (1987) Cranio-cerebral erosion (growing fracture of the skull in children). I. Pathology. Acta Neurochir (Wien) 87:112–118
Tandon PN, Banerji AK, Bhatia R, Goulatia RK (1987) Cranio-cerebral erosion (growing fracture of the skull in children). II. Clinic and radiological observations. Acta Neurochir (Wien) 88:1–9
Taveras JM, Ransohoff J (1953) Leptomeningeal cysts of the brain following trauma with erosion of the skull. J Neurosurg 10:233–241
Till K (1975) Paediatric neurosurgery for paediatricians and neurosurgeons. Blackwell, Oxford
Winston K, Beatty RM, Fischer EG (1983) Consequences of dural defects acquired in infancy. J Neurosurg 59:839–846
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Johnson, D.L., Helman, T. Enlarging skull fractures in children. Child's Nerv Syst 11, 265–268 (1995). https://doi.org/10.1007/BF00301756
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00301756