Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Growing skull fractures: progressive evolution of brain damage and effectiveness of surgical treatment

  • 48 Accesses

  • 31 Citations

Abstract

The growing skull fracture of childhood is a well-known but variously interpreted syndrome. Attempts have been made to find different pathogeneses for clinical and pathological patterns that are really successive phases of a single process, arising from the interaction of three basic conditions: (1) head injury with a large gaping fracture; (2) corresponding dural tear; (3) occurrence nearly always in infancy (the first year of life or period of maximum brain growth). This combination of factors alters the normal distribution of the intracranial pressure vectors and the fracture behaves like a “neosuture” with abnormal growth of the skull on the injured side. Simultaneously, the ventricular system tends to deform, dilating and shifting towards the side of the fracture. Three cases, successfully treated at a very late stage, are described. The good surgical results confirm the validity of the surgical method and its underlying theoretical basis.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Cantore GP, Angelotti A, Mariottini A, Delfini R, Ciappetta P (1984) Reconstruction of integument, bone and dura in the head injured. In: Neurotraumatology. Collana “Il dolore oggi”, CIC Edizioni Internazionali, Rome, pp 267–316

  2. 2.

    Freeman LM, Rosenthal D, Goldstein FP (1969) Experimental observations on adult growing skull fractures. Wis Med J 68:188–190

  3. 3.

    Goldstein FP, Sakoda T, Kepes JJ, Davidson K, Brackett CE (1967) Enlarging skull fractures: an experimental study. J Neurosurg 27:541–550

  4. 4.

    Goldstein FP, Rosenthal SAE, Garancis JC, Larson SJ, Brackett CE (1970) Varieties of growing skull fractures in childhood. J Neurosurg 33:25–28

  5. 5.

    Hochwald GM, Epstein F, Malhan C, Ransohoff J (1972) The role of the skull and dura mater in experimental feline hydrocephalus. Dev Med Child Neurol 14 [Suppl 27]:65–69

  6. 6.

    Ito H, Miwa T, Onodra Y (1977) Growing skull fracture of childhood. Child's Brain 3:116–126

  7. 7.

    Lende RA (1974) Enlarging skull fractures of childhood. Neuroradiology 7:119–124

  8. 8.

    Lende RA, Erickson TC (1961) Growing skull fractures of childhood. J Neurosurg 32:680–683

  9. 9.

    Lye RH, Occleshaw JV, Dutton J (1981) Growing fracture of the skull and the role of computerized tomography. Case report. J Neurosurg 55:470–472

  10. 10.

    Moss ML (1975) Functional anatomy of cranial synostosis. Child's Brain 1:22–34

  11. 11.

    Penfield W (1941) [Quoted by Goldstein FP et al (1970)]

  12. 12.

    Rao BD (1976) An unusual case of growing fracture of the skull in childhood. Br J Surg 63:145–146

  13. 13.

    Rothman L, Rose JS, Laster DW, Quencer R, Tenner M (1976) The spectrum of growing skull fracture in children. Pediatrics 57:26–31

  14. 14.

    Scammon RE, Dunn HL (1922) Empirical formulae for the postnatal growth of the human brain and its major divisions. Proc Soc Exp Biol Med 20:114–117

  15. 15.

    Scarfò GB, Tomaccini D (1976) Singolare malformazione cranioencefalica in M. di Crouzon. Riv Ital Pediatr (IJP) 2:39–42

  16. 16.

    Scarfò GB, Tomaccini D, Piane R (1980) The latent hazard of growing skull fracture in childhood. Riv Ital Pediatr (IJP) 6:637–641

  17. 17.

    Taveras J, Ransohoff J (1953) Leptomeningeal cysts of brain following trauma with erosion of skull, a study of seven cases treated by surgery. J Neurosurg 10:233–241

Download references

Author information

Correspondence to G. B. Scarfò.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Scarfò, G.B., Mariottini, A., Tomaccini, D. et al. Growing skull fractures: progressive evolution of brain damage and effectiveness of surgical treatment. Child's Nerv Syst 5, 163–167 (1989). https://doi.org/10.1007/BF00272120

Download citation

Key words

  • Infant trauma
  • Diastatic linear skull fracture
  • Dural tear
  • Post-traumatic leptomeningeal cyst
  • Post-traumatic porencephaly
  • Post-craniectomy ventricular enlargement
  • Growing skull fracture