Growing skull fracture: Delayed presentation, surgical management, and review of the literature.

Authors

Souleymane Mahamadou Ango, Ibrahim Assoumane Issa, Ousmane Issoufou Hamma, Rabiou Maman Sani, Mamane Maikassoua, Aminath Kelani

Published in

Surgical neurology international. Volume 17. Pages 524. Epub Sep 18, 2026.

Abstract

Growing skull fracture (GSF), also known as post-traumatic leptomeningeal cyst, is a rare late complication of a linear skull fracture in young children. It requires an underlying dural tear with progressive herniation of arachnoid membrane and/or brain tissue.
We report a 15-month-old child who sustained a right frontoparietal linear skull fracture at 1 month of age and returned 14 months later with a pulsatile scalp swelling and left hemiparesis. Computed tomography showed a wide right frontoparietal diastasis and adjacent ventricular dilatation. At surgery, the 10 × 3 cm defect was densely adherent to the arachnoid and ependymal surface. Adhesiolysis and watertight galeal duraplasty were performed, and the bone flap was replaced. The findings were most consistent with Naimur-Rahman type III GSF. Motor function recovered almost completely by 6 months, while follow-up at 6 and 12 months showed partial closure of the residual osseous gap.
GSF should be suspected when delayed scalp swelling or neurological deficits follow an infant skull fracture. Selective follow-up of high-risk fractures and timely watertight dural repair can limit progressive morbidity.

PMID:
42829693
Bibliographic data and abstract were imported from PubMed on 04 Oct 2026.

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