Growing skull fracture in an adult nine years after blunt head trauma

Abstract

Growing skull fracture (GSF) is an uncommon but well recognized complication of calvarial fracture in infancy and early childhood. The condition is rare in adults, and involvement of the skull base in this group of patients affects mostly the orbital roof. We present a patient with an unusual GSF involving the cribriform plate in a 37-year-old man who presented with late-onset epilepsy and recurrent meningitis 9 years after the initial trauma. Imaging studies revealed an associated intraethmoidal meningoencephalocele. The patient recovered well after a limited transcranial repair with preservation of olfactory function. A high index of suspicion should be exercised in the management of patients who present with these symptoms even many years after injury.