Background: When children younger than three years suffer a closed-head injury such as a fall or a blow to the head, a linear calvarial fracture may occur, leading to a growing skull fracture. Methods: In this prospective study, we provide 10 instances to better illuminate the symptoms of GSF, facilitate earlier surgical correction, and prevent negative outcomes by the use of specific technical details.
Results: Early surgical correction was performed for all patients showing evidence of dural tear and GSF, such as a pulsating, non-resolving subgaleal collection despite medical treatment, a fracture diastasis, a leptomeningeal cyst on magnetic resonance imaging, or a herniated brain via a fissure. After a skin incision was made including the fissure, a bone flap was created using electric craniotomy from the fracture's edge to minimize bony defects without the use of a burr hole. Next, the dura was dissected away from the fracture's edges, and finally, the underlying arachnoid adhesions and devitalized brain tissues were addressed before the dural closure was made. Results were better and complications such as increased intracranial pressure, prolonged CSF leak after surgery, meningitis, and skull abnormalities were avoided with early surgery.
Conclusions: Patients with linear skull fractures following closed head injuries require close monitoring and follow-up. Knowing the warning signals of GSF is important for parents. In the presence of symptoms and radiographic evidence of a dural rupture, early surgical repair is required to avoid neurological impairment, seizures, and elevated intracranial pressure. |
