Neglected growing skull fracture presenting in adulthood: A case report

Abstract

Introduction and importance: Growing skull fracture is one the rarest complication of skull fracture. They are identified mostly in infancy and children's, secondary to head trauma but there exist possibility of missed diagnosis in childhood and patient presenting in adulthood with delayed complications. Hence timely diagnosis and prompt management is mandatory.

Case summary: A 26 years old female presented two decades later with bony scalp swelling associated with neurological complaints and cosmetic deformity. In depth history and workup diagnosed it a growing skull fracture. Patient underwent excision of the defect along with titanium mesh cranioplasty.

Discussion: Among the cases of skull fracture, growing skull fracture is least encountered entity. Such fractures gets usually diagnosed very early after trauma, rarely it have been encountered decades later. More the delay more complications the patient usually presents with. Intraoperatively as well anatomy can be altered resulting difficulty in definitive management, however titanium mesh cranioplasty comes handy in bringing about good outcomes.

Conclusion: Childhood traumas are most neglected mostly in lower middle income countries hence the delay in intervention and future complications. If any forms of definitive injury could be diagnosed immediately after trauma such misfortunate presentation decades later can be prevented and quality of life the patient can be maintained.

Keywords: Cranioplasty; Delayed diagnosis; Growing skull fracture; Leptomeningeal cyst; Skull fracture.