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Cranio-cerebral erosion (growing skull fracture): Management by lumber-peritoneal shunt

Yad Ram Yadav

CaseRepClinPractRev 2005; 6:224-229

ID: 428468

Published:


Background: Cranio-cerebral erosion is due to bulging of brain or cyst through the defect. There are evidences in the literature that the abnormal cerebro-spinal fluid (CSF) dynamics do exist in some
patients of cranio-cerebral erosion. Recurrent cases after conventional methods and difficult to treat cases were successfully managed by shunt surgery, also point towards abnormal CSF dynamics at least in some cases.
Case report: Three female children of 6 years, 2 years and 10 months of age of growing skull fracture were successfully managed by lumber-peritoneal shunt. The fracture was in orbital roof, occipital and
parietal regions. There was porencephalic cyst or subdural hygroma in all cases. Lumber puncture
resulted in complete disappearance of swelling from skull defect. There was no recurrence at 2, 3 and 4 year follow up. Only one patient had focal neuro deficit which showed improvement after shunt.
Conclusions: Shunt surgery is an effective alternative to conventional surgery when swelling from the skull defect subsides after lumber puncture. It is simple and safe.

Keywords: Growing skull fracture, cranio-cerebral erosion, shunt surgery, cerebro-spinal fluid hydrodynamics, cerebral herniation



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