Depressed skull fractures in pediatrics [Neurosurgery Wiki]

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====== Depressed skull fractures in pediatrics ======

{{ ::depressed_skull_fractures_in_pediatrics11358.jpg?200|}}

===== General information =====

Most common in frontal and [[parietal bone]]s. One third are closed, and these tend to occur in younger children (3.4 ± 4.2 yrs, vs. 8.0 ± 4.5 yrs for compound fractures) as a result of the thinner, more deformable [[skull]]. Open fractures tended to occur with MVAs, closed fractures tended to follow accidents at home. [[Dural laceration]]s are more common in compound fractures.

==== Simple depressed skull fractures ====

There was no difference in outcome (seizures, neurologic dysfunction or cosmetic appearance) in
surgical vs. nonsurgical treatment in 111 patients < 16 yrs of age. In the younger child, remodelling
of the skull as a result of brain growth tends to smooth out the deformity.

Indications for surgery for pediatric simple depressed skull fracture:

1. definite evidence of dural penetration

2. persistent cosmetic defect in the older child after the swelling has subsided

3. ± focal neurologic deficit related to the fracture (this group has a higher incidence of dural laceration,
although it is usually trivial).

==== Ping pong skull fracture ====

see [[Ping pong skull fracture]]