Enlarging Skull Fracture treated by Early Surgery

Case Report

Yoshihiro Yamamoto, Katsuzo Kunishio, Norio Sunami, Yuji Yamamoto

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The authors report a case in which an enlarging skull fracture was surgically repaired on the fourth day after the initial injury. A 5-month-old boy fell from his father's arms and was hospitalized with a large, irregular protrusion in the left parieto-occipital region and right hemiparesis. Plain skull films showed a diastatic linear fracture with a maximum width of 8 mm, which expanded to 11 mm by the fourth day. Computed tomography (CT) scans revealed a cerebral contusion just beneath the fracture as well as a left subdural effusion. At operation, the contused brain tissue was found to have herniated over the bone defect. Craniotomy revealed a large dural defect, which was repaired with lyophilized dura. The patient was discharged with no neurological deficit. On the basis of a review of 58 recently reported cases of skull fracture, the authors conclude that the following conditions warrant consideration of early surgery: 1) a diastatic skull fracture with a width of at least 4 mm; 2) CT demonstration of a cerebral contusion beneath the fracture; 3) overlying scalp swelling; and 4) a neurological abnormality contralateral to the fracture. Performing surgery before the fracture gap becomes scalloped will result in more rapid neurological recovery and reduce the likelihood of enlargement of the fracture.

Original languageEnglish
Pages (from-to)137-141
Number of pages5
JournalNeurologia Medico-Chirurgica
Volume29
Issue number2
DOIs
Publication statusPublished - Jan 1 1989
Externally publishedYes

Fingerprint

Skull Fractures
Subdural Effusion
Tomography
Occipital Lobe
Contusions
Craniotomy
Paresis
Motion Pictures
Scalp
Skull
Fathers
Arm
Bone and Bones
Wounds and Injuries
Brain
Brain Contusion

Keywords

  • cerebral contusion
  • computed tomography
  • diastatic skull fracture
  • head trauma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Enlarging Skull Fracture treated by Early Surgery : Case Report. / Yamamoto, Yoshihiro; Kunishio, Katsuzo; Sunami, Norio; Yamamoto, Yuji.

In: Neurologia Medico-Chirurgica, Vol. 29, No. 2, 01.01.1989, p. 137-141.

Research output: Contribution to journalArticle

Yamamoto, Yoshihiro ; Kunishio, Katsuzo ; Sunami, Norio ; Yamamoto, Yuji. / Enlarging Skull Fracture treated by Early Surgery : Case Report. In: Neurologia Medico-Chirurgica. 1989 ; Vol. 29, No. 2. pp. 137-141.
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