GROWING SKULL FRACTURES AND THEIR CRANIOFACIAL EQUIVALENTS

Growing skull fractures occur most commonly after head injury; however , their ''craniofacial equivalents'' may occur after neurosurgical or craniofacial operations in pediatric patients. Experience with five se parate cases is reviewed, including one case that involved the anterio r cranial base and presented with vertical dystopia and proptosis. Nec essary contributing factors appear to include (1) cranial bone defect, (2) dural tear, and (3) expanding intracranial process (e.g., growth of the brain). Prompt recognition and diagnosis of the problem are ess ential to prevent the development of progressive neurological complica tions. The pathophysiology and the principles of surgical management o f these complex problems are explored in detail.