Presentation
History of old trauma and surgical intervention for treatment of epidural hematoma. Bulging head swelling with progressive course since then.
Patient Data
Age: 7 years
Gender: Male
From the case:
Growing skull fracture
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Axial non-contrast
- left parietal large calvarial defect
- left temporo-parietal area of encephalomalacia underlying the fracture, sequel of old cerebral contusion
- the left temporo-parietal area of encephalomalacia and adjacent leptomeninges are protruding through the large bone defect
- right frontal area of encephalomalacia, sequel of old cerebral contusion (counter-coup)
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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