Expanded skull fracture in childhood

Abstract

Skull fractures in infants usually heal without difficulty, but occasionally the fracture cannot be repaired and instead expands to form a permanent skull defect. This condition is often a syndrome that includes dissociative skull fractures, torn and separated dural mater, brain contusion and swelling deep within the fracture, and fracture enlargement with persistent skull defects. Local brain injury is common in the deep side of the extended fracture, which can produce different consequences, including localized brain atrophy, penetrating malformation or other cyst formation, localized ventriculomegaly, and complex scars involving the dura mater, arachnoid mater, and brain tissue. Dural defects are important in the formation of this syndrome. Shortly after trauma, the dural defect can become wide. In a recent acute case, the edge of the dural defect extended 3 mm beyond the fracture margin.