Growing skull fracture in a child: A rare sequala of paediatric head trauma

Raghavendra H, Kodali S, Lingabathina S, Chawla N, Alekhya R, Rao S, Reddy G, Jakka S, Shetty VK, Varsha KS

Pdf Page Numbers :- 28-30

Raghavendra H¹,*, Sandhya Kodali¹, Suman Lingabathina², Nithin Chawla², Rodda Alekhya², Suhasini Rao³, Girish Reddy³, Shrisha Jakka⁴, Vamsi Krishna Shetty⁴ and Varsha KS⁵

¹Department of Neurosurgery, KIMS Hospital, Gachibowli, Hyderabad, Telangana 500032, India

²Department of Pediatrics, KIMS Hospital, Gachibowli, Hyderabad, Telangana 500032, India

³Department of Anesthesia, KIMS Hospital, Gachibowli, Hyderabad, Telangana 500032, India

⁴Department of Radiology, KIMS Hospital, Gachibowli, Hyderabad, Telangana 500032, India

⁵Department of Anesthesia, MNJ Cancer Hospital, Lakadikapul, Hyderabad, Telangana 500004, India

*Corresponding author: Dr. Raghavendra Harpanahalli, Department of Neurosurgery, KIMS Hospital, Gachibowli, Hyderabad, Telangana 500032, India. Email: harpanahalli.raghavendra@gmail.com

Received 6 October 2025; Revised 26 November 2025; Accepted 5 December 2025; Published 13 December 2025

Citation: Raghavendra H, Kodali S, Lingabathina S, Chawla N, Alekhya R, Rao S, Reddy G, Jakka S, Shetty VK, Varsha KS. Growing skull fracture in a child: A rare sequala of paediatric head trauma. J Med Sci Res. 2026; 14(1):28-30. DOI: http://dx.doi.org/10.17727/JMSR.2026/14-5

Copyright: © 2026 Raghavendra H et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Growing skull fracture (GSF) is an uncommon but well-recognized complication of pediatric head trauma, predominantly affecting children under three years of age. It arises from a skull fracture associated with an underlying dural tear, leading to herniation of leptomeninges or brain tissue and progressive widening of the fracture defect. This case report aims to highlight the importance of early diagnosis and timely surgical management of growing skull fracture to achieve optimal neurological and cosmetic outcomes in children.

Case presentation: We report the case of a 3-year-old male who presented with a progressively enlarging, pulsatile swelling over the left frontal region for a duration of two months. There was a history of minor head trauma following a fall approximately 15 months prior. Neuroimaging revealed a left frontal bone defect with an associated dural tear and herniation of cortical tissue, consistent with a growing skull fracture. The patient underwent surgical management, including excision of gliotic brain tissue, duraplasty using an autologous pericranial graft, and cranioplasty with the native bone. The postoperative course was uneventful. At 3-month follow-up, the child remained neurologically intact with no evidence of recurrence.

Conclusion: Growing skull fracture, though rare, should be suspected in children presenting with progressive scalp swelling following head trauma. Early diagnosis and timely surgical intervention are essential to prevent neurological complications and achieve favorable functional and cosmetic outcomes.

Keywords: Growing skull fracture; pediatric head trauma; dural tear; duraplasty; cranioplasty