Turkish Neurosurgery
2011 , Vol 21 , Num 3
Elevated Skull Fractures in Pediatric Age Group: Report of Two Cases
SKIMS, Department of Neurosurgery, Srinager/ J&K, India
DOI :
10.5137/1019-5149.JTN.2913-10.0
Elevated fractures of the skull, which are rarely reported in the literature, are always compound, have maximal neurological deficits at
presentation and have been reported only in adults. We report two cases of elevated skull fractures in the pediatric age group, one of which
was a simple elevated fracture and presented with delayed neurological deterioration. The etiologies were a fall in first case and an animal
attack (bear maul) in the second case as reported for the first time. One of the cases presented with delayed onset of left focal hemispheric
signs. The first case underwent debridement, duraplasty and reduction of fracture whereas in the second case the bone flap was not replaced
immediately because of gross contamination. Both patients had an excellent outcome. Elevated skull fractures are not uncommon in the
pediatric age group. Compound elevated skull fractures should be managed early as open depressed fractures. Reduction of a simple elevated
fracture presenting with neurological deficits not explained by any other lesion can result in a good outcome.
Keywords :
Skull fractures, Elevated skull fractures, Compound fractures, Simple fractures, Pediatric age group