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Eolchiyan S.A.

Burdenko Neurosurgical Center

Chelushkin D.M.

Burdenko Neurosurgical Center

Serova N.K.

Burdenko Neurosurgical Center

Sergeeva L.A.

Burdenko Neurosurgical Center

Batalov A.I.

Burdenko Neurosurgical Center

Cherebylo S.A.

Kurchatov Research Institute

Growing skull fracture of the orbital roof: case report and literature review

Authors:

Eolchiyan S.A., Chelushkin D.M., Serova N.K., Sergeeva L.A., Batalov A.I., Cherebylo S.A.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2024;88(5): 77‑86

DOI: 10.17116/neiro20248805177

Views: 492

Downloaded: 24

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To cite this article:

Eolchiyan SA, Chelushkin DM, Serova NK, Sergeeva LA, Batalov AI, Cherebylo SA. Growing skull fracture of the orbital roof: case report and literature review. Burdenko's Journal of Neurosurgery. 2024;88(5):77‑86. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248805177

Подписка 2025 (Burdenko's Journal of Neurosurgery)
 
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BACKGROUND

Growing skull fracture (GSF) of the orbital roof is a rare complication of head injury in infancy and early childhood. Analysis of the Medline database between 1983 and 2023 identified 17 articles describing 63 children after surgical treatment of GSF of the orbital roof.

MATERIAL AND METHODS

We present a 2-year-old child with moderate traumatic brain injury (TBI) complicated by GSF of the orbital roof. Neuroimaging and literature data are described.

RESULTS

Severe ophthalmological symptoms in acute period of TBI subsequently partially regressed with persistent swelling of the upper eyelid and hypophthalmos. CT and MRI revealed a linear fracture of the frontal bone extending to superior orbital wall and intraorbital collection of cerebrospinal fluid (pseudomeningocele) mixed with blood. MR signs of GSF of the orbital roof with pseudomeningocele shrinkage were found in 5 weeks after injury. After 6 months, CT and MRI revealed signs of more severe GSF. Surgical treatment implied craniotomy, excision of scars, arachnoid membrane and abnormal brain matter, resection of deformed fracture edges, dura mater sealing and orbital roof reconstruction with bone autograft. Ophthalmological symptoms regressed after 6 months. The follow-up period was 6 years. There were no signs of fracture recurrence.

CONCLUSION

In this case, acute intraorbital pseudomeningocele led to GSF of the orbital roof in 5 weeks after injury. Incomplete regression of ophthalmological symptoms, their aggravation or delayed appearance in children with orbital roof fracture requires a thorough examination including high-resolution CT and MRI, and orbital roof GSF should be considered in the differential diagnosis.

Keywords:

growing skull fracture
traumatic brain injury
skull base
superior orbital wall
pseudomeningocele
leptomeningeal cyst
children
computed tomography
magnetic resonance imaging

Authors:

Eolchiyan S.A.

Burdenko Neurosurgical Center

Chelushkin D.M.

Burdenko Neurosurgical Center

Serova N.K.

Burdenko Neurosurgical Center

Sergeeva L.A.

Burdenko Neurosurgical Center

Batalov A.I.

Burdenko Neurosurgical Center

Cherebylo S.A.

Kurchatov Research Institute

Received:

22.03.2024

Accepted:

21.06.2024

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