Affiliations: Department of Neurosurgery B, Pierre Wertheimer
Hospital, Lyon, France | Department of Neurosurgery, National Institute of
Neurology, Tunis, Tunisia
Note: [] Correspondence: Moncef Berhouma, MD, Department of Neurosurgery
B, Pierre Wertheimer Neurological and Neurosurgical Hospital, 59 Boulevard
Pinel 69677 Bron Cedex, Lyon, France. Tel.: +33 6 42 46 88 31; E-mail:
[email protected]; [email protected]
Abstract: Growing skull fractures are rare complications of head injury,
affecting almost exclusively young children. This disease is characterized by
the progression of a skull fracture with an underlying dural tear, leading to
large cranial vault defects and parenchymal porencephalic damages. This report
on three cases with a radiological follow-up depicts the difficulty in the
management of neglected cases. Three young patients (two months, two years and
six years old) were managed for growing skull fracture in our department since
2001. Even if the three patients were diagnosed early, the therapeutic
management was complex because of a long delay due to several reasons. While a
cranioplasty and dural repair were performed in all patients, one required a
shunt procedure for a large leptomeningeal cyst associated with a unilateral
hydrocephalus. The clinical and radiological features are reviewed, as well as
pathophysiological hypotheses and therapeutic principles.
Keywords: Leptomeningeal cyst, growing skull fracture, head trauma, encephalomalacia, cranioplasty, head injury sequelae
