De 'groeiende schedelfractuur'

Growing skull fracture (GSF) is a rare complication of cranial trauma in children younger than 3 years. It is characterised by the presence of a dural defect due to which herniation of the brain tissue can develop, with cystic transformation and resulting cerebral damage. A 5-month-old baby girl presented at the emergency department following a fall from the staircase. Upon examination she showed a left parietal subgaleal haematoma and right-sided hemiparesis. MRI examination of the brain showed a skull fracture and dural defect with progressive herniation of the brain tissue. Neurosurgical reconstruction was carried out. GSF is a rare complication of cranial trauma in young children as a result of rupture of the dura and separating fracture edges. This can lead to cerebral damage and early recognition is important. GSF needs to be considered in children younger than 3 years with a (pulsating) subgaleal haematoma. The diagnosis is made by MRI scan of the brain and neurosurgical treatment consists of watertight closure of the dura combined with skull reconstruction.