Unusual Complication of a Neglected Growing Skull Fracture

2021 ◽  
Vol 56 (2) ◽  
pp. 179-183
Author(s):  
Akshay Vijay Kulkarni ◽  
Priyadarshi Dikshit ◽  
B. Indira Devi ◽  
Nishanth Sadashiva ◽  
Dhaval Shukla ◽  
...  
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Rare Complication ◽  
Skull Fracture ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Unusual Complication ◽  
Bony Defect ◽  
Dural Defect ◽  
Growing Skull Fracture

<b><i>Introduction:</i></b> The growing skull fracture (GSF) is a rare complication seen after head injury in infants and young children. It occurs due to a wide skull defect with underlying dural defect and changes in pressure gradients within skull cavity. Neglected cases may develop progressive neurological deficits and complications after second head trauma. <b><i>Case Discussion:</i></b> We present a 14-year-old child who developed sudden-onset, diffuse, soft, fluctuant, circumferential swelling of the head after a road traffic accident. He had sustained a head injury at the age of 3-months leading to an asymptomatic soft swelling over the skull which was left untreated. Present CT scan of the brain showed a bony defect with ragged edges and cerebrospinal fluid (CSF) collection in subgaleal space circumferentially. He underwent exploration, duroplasty, and cranioplasty and had a good outcome. <b><i>Conclusion:</i></b> Neglected GSF can rupture and cause diffuse subgaleal CSF collection. It should be managed with dural repair and cranioplasty.

The growing skull fracture, a rare complication of paediatric head injury

2003 ◽  
Vol 162 (7-8) ◽  
pp. 556-557 ◽  
Author(s):  
Bas Zegers ◽  
Petr Jira ◽  
Michel Willemsen ◽  
Jan Grotenhuis
Keyword(s):  
Head Injury ◽  
Rare Complication ◽  
Skull Fracture ◽  
Growing Skull Fracture ◽  
Paediatric Head Injury

scholarly journals Growing skull fracture in a 2 months old child

2015 ◽  
Vol 29 (3) ◽  
pp. 285-288
Author(s):  
A. Tascu ◽  
Iulia E.B. Vapor ◽  
A. Iliescu ◽  
Irina Tudose ◽  
St.M. Iencean
Keyword(s):  
Head Trauma ◽  
Rare Complication ◽  
Skull Fracture ◽  
Dural Defect ◽  
Skull Fractures ◽  
Growing Skull Fracture ◽  
Leptomeningeal Cyst ◽  
Neurologic Deficits ◽  
Bone Fragments ◽  
Closed Head Trauma

Abstract A growing skull fracture, also called posttraumatic leptomeningeal cyst, is a rare complication of skull fractures - less than 1%, usually encountered in children younger than 3 years old. Although rare, this complication must be recognized early and treated to prevent permanent neurologic deficits. We present the case of a 2 months old child who had suffered a closed head trauma in a car accident 2 weeks before he was admitted in our clinic with a left parietal growing skull fracture. He was submitted to surgery and leptomeningeal cyst was evacuated, dural defect repaired and bone fragments fixed. Child was discharged 6 days postoperative without neurologic deficits. Growing skull fractures represent a rare complication of head trauma in small children. It is imperious to be recognized and treated in early phases to prevent debilitating permanent neurologic deficits in that category of population.

“Post Traumatic Brain Abscess Mimicking as Pneumatocele”: An Uncommon Presentation

2018 ◽  
Vol 15 (01) ◽  
pp. 036-038
Author(s):  
Rahul Varshney ◽  
Nitin Bhakal ◽  
L. Gupta ◽  
Sharad Pandey ◽  
Rajesh Sharma
Keyword(s):  
Head Injury ◽  
Brain Abscess ◽  
Road Traffic ◽  
Rare Complication ◽  
Dural Defect ◽  
Csf Rhinorrhea ◽  
Nonsurgical Management ◽  
Depressed Fracture ◽  
Uncommon Presentation ◽  
Threatening Condition

AbstractPneumatocele is a very rare complication that follows head injury. Pneumatocele can result due to a craniodural fistula, formed either after a fracture involving air sinuses, roof of middle ear, or depressed fracture of skull. Gas-containing brain abscess is a life-threatening condition, which requires immediate diagnosis and prompt therapeutic intervention. The predisposing factors include hematogenous spread, contiguous infection, and abnormal fistulous communication due to head injury. This is a rare case in which the patient had a history of head trauma due to road traffic accident with frontal contusion and small pneumocephalus, which was managed conservatively 2 years earlier followed by cerebrospinal fluid (CSF) rhinorrhea after 2 months, which was also managed by nonsurgical management. He presented with intractable seizures and features of raised intracranial pressure (ICP) with imaging suggestive of air-containing cavity in frontal region (pneumatocele). Intraoperatively, there was brain abscess with dural defect for which abscess was excised, and dural repair with exteriorization of frontal sinus was done.

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

scholarly journals Skull Fracture and Haemorrhagic Pattern in Cases of Fatal Blunt Trauma Head Injury Autopsied at Tertiary Healthcare Centre in Eastern Nepal

Med Phoenix ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 71-74
Author(s):  
Bikash Sah ◽  
Bishwanath Yadav ◽  
Shivendra Jha ◽  
Abdul Sami Khan
Keyword(s):  
Head Injury ◽  
Subarachnoid Haemorrhage ◽  
Blunt Trauma ◽  
Intracranial Haemorrhage ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Skull Vault

Background: Head injury is regarded as a main health problem that is a common cause of morbidities and mortalities and makes great demand to control and prevent it. For this, policy makers need to see the pattern of head injury and this study is done to describe the pattern.Methods: Hospital based, descriptive cross sectional study done on one year autopsy cases of fatal blunt trauma head injury which was 76 in which proportion of different types of head injuries, their causes and their distribution as per age, sex, and duration of survival were studied.Results: Skull-vault fractures were present in 57 (75%) cases in which most common type of fracture was linear fracture constituting 29(49.12%). 50% of the cases were with skullbase fracture in which the most common was of anterior cranial fossa fracture(60.5%). 56.34% of the victims were with subarachnoid haemorrhage (SAH) followed by subdural haemorrhage (SDH) and extradural haemorrhage (EDH). 6.6% victims were without any intracranial haemorrhage. Road traffic accident alone accounted for 71% of total blunt trauma causations of this fatal head injury. 70% cases were in age group from 11 to 50 years and 78.9% were male. 51.3% died at the spot. Conclusions: The research findings have shown that among the fatal blunt trauma head injury cases, skull vault fracture was present in 75% and skull base fracture was present in 50%. The most common intracranial haemorrhage was subarachnoid haemorrhage (56.34%) followed by subdural and extradural haemorrhage.  Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 71-74                                                         

scholarly journals An Unusual Presentation of Growing Skull Fracture with Sutural Diastasis

2020 ◽  
Vol 17 (01) ◽  
pp. 53-56
Author(s):  
Gaurav Sharma ◽  
Gaurav Jain ◽  
Jitendra Shekhawat ◽  
Sanjeev Chopra ◽  
Virendra Deo Sinha
Keyword(s):  
Rare Complication ◽  
Skull Fracture ◽  
Unusual Presentation ◽  
Skull Fractures ◽  
Parietal Region ◽  
Review Of Literature ◽  
Common Site ◽  
Growing Skull Fracture ◽  
Delayed Onset ◽  
Rare Site

AbstractGrowing skull fracture (GSF) is a rare complication of childhood skull fractures, which is caused by progressive diastatic enlargement of the fracture line. Progressive swelling is the most common presenting feature. The most common site is the parietal region. Sutural diastasis is a rare site for development of GSF. Early treatment is must as they cause delayed onset neurological deficit and cranial asymmetry. The aim of this report is to discuss an unusual presentation of GSF with sutural diastasis and review of literature.

scholarly journals Role of CT(Computed Tomography) in Head Injury

2016 ◽  
Vol 2 ◽  
pp. 45-52
Author(s):  
Bibek Khadka ◽  
Prabin Kumar Deka ◽  
Alina Karki
Keyword(s):  
Computed Tomography ◽  
Head Injury ◽  
Severe Head Injury ◽  
Road Traffic ◽  
Skull Fracture ◽  
Craniocerebral Trauma ◽  
Skull Fractures ◽  
Substantial Impact ◽  
Major Health Problem ◽  
Female Ratio

Background: Head injury is considered as a major health problem that is a frequent cause of death and disability and makes considerable demands on health services. CT remains essential for detecting lesions that require immediate neurosurgical intervention as well as those that require in-hospital observation and medical management.Objectives: To evaluate the computed tomography findings in patients sustaining head injury and to emphasize the importance of computed tomography scan in head injury.Methodology: The study was conducted for the period of one year .It comprised a total number of eighty patients presenting to the emergency room(ER) with head injury and were evaluated by CT scan of head using siemens somatom dual slice spiral CT machine.Results: the study showed overall male to female ratio as 2.6:1. Head injury was most common in 31-50years of age group. Road traffic accidents (RTA) was the commonest mode of injury seen in 65% of patients. Loss of consciousness followed by vomiting and seizures were the common clinical presentations in head trauma patients respectively. According to Glasgow coma scale( GCS), most of the patients (68.8%)sustained mild head injury( GCS13-15). Most common abnormal CT findings were skull fractures 39(48.8%), extradural hematoma 31 ( 38.8%), subdural hematoma 21(26.2%) ,contusions 21(26.2%), subarachnoid hemorrhage14 ( 17.5%) and pneumocephalous 13 (16.2%) respectively. Linear skull fracture was the commonest among all other skull fractures. Patients sustaining severe head injury were mostly due to RTA (77%). The highest mortality was seen in patients with severe head injury (GCS 3-8). 5% also had cervical spine injury.Conclusion: CT is the most comprehensive diagnostic modality for accurate localization of the site of injury in craniocerebral trauma. The early and timely diagnosis of the precise lesion by CT not only had the substantial impact over instituting appropriate treatment and timely surgical intervention but also helped in predicting the ultimate outcome.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.45-52

scholarly journals Exercise-Induced Hypoglycemic Hemiplegia in a Child with Type 1 Diabetes: A Rare Find with Multiple Potential Causative Mechanisms

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
M. Constantine Samaan ◽  
Abeer Alassaf ◽  
Jonathan DellaVedova ◽  
Trisha Murthy
Keyword(s):  
Type 1 Diabetes ◽  
Motor Neurons ◽  
Intracellular Signaling ◽  
Rare Complication ◽  
Sudden Onset ◽  
The Body ◽  
Neurological Deficits ◽  
Oral Glucose ◽  
Normal Brain

A 10-year-old boy known to have type 1 diabetes presented to the emergency department with history of sudden onset of right-sided hemiplegia after exercise. He did not respond to oral glucose administration, but had an almost immediate resolution of symptoms with intravenous bolus of dextrose. Hemiplegic hypoglycemia is a rare complication in diabetic children, mostly affects the right side of the body, and is rarely recurrent. Children have normal brain imaging and angiography testing, and electroencephalogram may show slow-wave activity. The recovery takes place within 24 hours, and the prognosis is excellent with no focal neurological deficits noted. Our patient responded within minutes to intravenous dextrose, which is unusual and has not been reported previously. The mechanisms leading to development of hypoglycemic hemiplegia are unclear, but may involve effects of hypoglycemia on intracellular signaling pathways or molecules on motor neurons, as recent studies have shown normal brain cell glucose uptake and metabolism in hypoglycemia. While hypoglycemic hemiplegia is rare, it is a frightening experience to caregivers, and efforts should concentrate on its prevention by preventing hypoglycemia.

Growing skull fracture stages and treatment strategy

2012 ◽  
Vol 9 (6) ◽  
pp. 670-675 ◽  
Author(s):  
Xue-song Liu ◽  
Chao You ◽  
Ma Lu ◽  
Jia-gang Liu
Keyword(s):  
Treatment Strategy ◽  
Late Phase ◽  
Late Complication ◽  
Skull Fracture ◽  
Neurological Deficits ◽  
Growing Skull Fracture ◽  
Alloplastic Materials ◽  
Stage 1 ◽  
New Hypothesis

Object A growing skull fracture (GSF) is a rare but significant late complication of skull fractures, usually occurring during infancy and early childhood. Delayed diagnosis and improper treatment could exacerbate this disease. The aim of this study was to introduce a new hypothesis about, describe the stages of, and discuss the treatment strategy for GSF. Methods The authors performed a retrospective review of 27 patients with GSF, who were grouped according to 3 different GSF stages. Results Over a period of 20 years, 27 patients with GSF (16 males and 11 females) were treated in the authors' department. The mean follow-up period was 26.5 months. Six patients were in the prephase of GSF (Stage 1), 10 patients in the early phase (Stage 2), and 11 in the late phase (Stage 3). All patients underwent duraplasty. All 6 patients at Stage 1 and 5 patients at Stage 2 underwent craniotomy without cranioplasty. Five patients at Stage 2 and all of the patients at Stage 3 underwent cranioplasty with autologous bone and alloplastic materials, respectively. Among all patients, 5 underwent ventriculoperitoneal shunt placement. Symptoms in all patients at Stages 1 and 2 were alleviated or disappeared, and the cranial bones developed without deformity during follow-up. Among patients with Stage 3 GSF, no obvious improvement in neurological deficits was observed. Three patients underwent additional operations because of cranial deformation or infection. Conclusions The authors identify the stages of GSF according to a new hypothesis. They conclude that accurately diagnosing and treating GSF during Stages 1 and 2 leads to a better prognosis.

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