Growing skull fracture

Case contributed by Dalia Ibrahim

Presentation

Trauma 1 month ago. Recent right parietal progressive scalp swelling.

Patient Data

Age: 1 year
Gender: Male
ct
  • right parietal calvarial widened linear fracture.
  • right parietal area of encephalomalacia underlying the fracture.
  • right parietal subgaleal small cyst of CSF density was seen protruding through the fracture gap.
Annotated image

Growing skull fracture

Case Discussion

Leptomeningeal cysts, also known as growing skull fractures, are an enlarging skull fracture that occurs near post-traumatic encephalomalacia.

The exact pathogenesis remains unclear, but it is thought they occur secondary to skull fractures causing dural tears, allowing the leptomeninges and/or cerebral parenchyma to herniate into it. Pulsations from CSF erode the fracture margin, resulting in eventual expansion and non-union.

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