{"id":"f3cdc4ae-7caa-40bb-9904-dbdd9897cbee","slug":"sni-17-524","title":"Growing skull fracture: Delayed presentation, surgical management, and review of the literature","authors":["Souleymane Mahamadou Ango","Ibrahim Assoumane Issa","Ousmane Issoufou Hamma","Rabiou Maman Sani","Mamane Maikassoua","Aminath Kelani"],"abstract":"Background: Growing skull fracture (GSF), also known as post-traumatic leptomeningeal cyst, is a rare late complication of a linear skull fracture in young children. It requires an underlying dural tear with progressive herniation of arachnoid membrane and/or brain tissue. Case Description: We report a 15-month-old child who sustained a right frontoparietal linear skull fracture at 1 month of age and returned 14 months later with a pulsatile scalp swelling and left hemiparesis. Computed tomography showed a wide right frontoparietal diastasis and adjacent ventricular dilatation. At surgery, the 10 × 3 cm defect was densely adherent to the arachnoid and ependymal surface. Adhesiolysis and watertight galeal duraplasty were performed, and the bone flap was replaced. The findings were most consistent with Naimur-Rahman type III GSF. Motor function recovered almost completely by 6 months, while follow-up at 6 and 12 months showed partial closure of the residual osseous gap. Conclusion: GSF should be suspected when delayed scalp swelling or neurological deficits follow an infant skull fracture. Selective follow-up of high-risk fractures and timely watertight dural repair can limit progressive morbidity.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/sni-17-524/figures/SNI-17-524-g001.jpg","publishDate":"2026-09-18T00:00:00.000Z","doi":"10.25259/SNI_326_2026","categories":["Pediatric Neurosurgery","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/f3cdc4ae-7caa-40bb-9904-dbdd9897cbee/pdf"}