Growing skull fracture with leptomeningeal cyst associated with superior sagittal sinus thrombosis

Abstract

Growing skull fracture is a rare complication of head injury usually occurs during the first 3 years of life. It may be associated with cerebral herniation, subdural hygroma, and subgaleal cerebrospinal fluid collection (leptomeningeal cyst). Posttraumatic cerebral venous sinus thrombosis is also an unusual complication of head injury associated with skull fracture extending to a dural sinus or the jugular bulb. It may be associated with ischemic damage to adjacent brain parenchyma. We report the case of growing fracture with leptomeningeal cyst associated with superior sagittal sinus thrombosis. A 2-year-old female child presented to the hospital following head trauma. The patient was drowsy and had hypotonia of all four limbs. Computed tomography was performed which showed a linear fracture of bilateral parietal bone with superior sagittal sinus thrombosis, subgaleal scalp collection in the bilateral parietal region, and ischemic changes in adjacent bilateral parietal lobes. Follow-up magnetic resonance imaging was done after 12 days of conservative treatment which showed similar findings. Surgical correction was done without any intraoperative or postoperative complications. As the delay in treatment may be associated with neurological complications, early diagnosis and prompt treatment are essential to prevent it and imaging modalities help in the early diagnosis.