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2007, Number 2

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Rev Mex Cir Pediatr 2007; 14 (2)

Evolutionary Skull Fracture in Children. From diagnosis to surgery. Report of 18 cases

Abi-Lahoud G, Gutiérrez-Guerra RG, Vinchon M, Dhellemmes P, Gonzalez-Nieto E

Language: Spanish
References: 33
Page: 70-76
PDF size: 474.71 Kb.


ABSTRACT

Introduction: Growing skull fracture in children is a rare complication in head trauma. The knowledge of this entity is essential for avoiding complications.
Material and Methods: Retrospective study of 18 patients, from January of 1982 to February of 2005. The clinical and radiological exams confirm diagnosis. Surgical technique consists in craniotomy, gliosis dissection, duroplasty, and cranioplasty by bone flap transposition.
Results: 18 patients: 13 were boys and 5 were girls; ages from newborn to 4 years old (mean 14.6 months) at the moment of head trauma. Head trauma mechanism was: fall in 9 cases, car accident in 8 cases, and one case obstetrical trauma. Admission plain skull films shown lineal fracture. CT scan and MRI show in acute phase brain herniation, and leptomeningeal cyst in chronic phase. Surgical treatment was performing in all cases. Functional results were satisfactory in 15 cases and poor in 3, according to Glasgow Outcome Scale. Morphologic results were acceptable in all cases.
Conclusions: Physiopathology of this entity presumes the coincidence of bone and dural tear, and local hydrodynamic trouble. Treatment includes bone and dural injuries restoration by autologous graft.


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