Depressed skull fracture and epidural hematoma resulted from pin-type head holder for craniotomy in children

Abstract

A head fixation device with pins is commonly used for immobilization of the patient's head during craniotomy. The safety of head fixation devices in children has been discussed rarely in the literature. We present one case of depressed skull fractures and associated epidural hematomas resulted from pin-type head holder for craniotomy in young children. The patient received surgical hematoma evacuation and recovered well after the surgery. The incidence of such complications reported in the literature is <0.65%. Age ranged from 2.6 to 7.5 years; all fractures were temporal and occurred during posterior fossa craniotomies. In conclusion, depressed skull fractures and associated epidural hematomas need to be considered as possible complications, while we use the pin-type head holder for craniotomy in children in the daily practice.