A growing skull fracture- Operative steps.



Left frontal growing skull fracture in a child. Note the scalp swelling and also swelling of left upper eyelid. 3D CT head showing left frontal skull fracture with herniation of CSF outside the bone. A free bone flap was raised around the growing skull fracture. The large rent in dura was defined. Brain surface was separated from dural edges, so that CSF could go all around. A pericranial graft was used to cover the dural defect. Hitch sutures were applied at multiple places. Bone defect was covered with titanium mesh and all the bone was replaced. The zig-zag scalp incision was closed.

Below, photograph showing titanium mesh used to cover the calvarial defect.

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why a large craniotomy for a small rent?
written by ci0, February 18, 2014
the dural rent normally recedes under the skull defect hence a large circumferential craniotomy is required, to delineate the defect in the DURA.

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