GROWING FRACTURE OF THE ORBITAL ROOF

BACKGROUND Growing fractures rarely arise in the skull base, and their pathogenesis and treatment are still debated. METHODS The clinical an d radiologic findings of a growing fracture involving the orbital roof in a ti-year-old boy are presented and the relevant literature is rev iewed. RESULTS The clinical picture of growing fracture of the orbital roof is dominated by ocular symptoms such as diplopia, eyelid swellin g, and displaced eye globe. Computed tomography scan is excellent for demonstrating the bony defect in the orbital roof while magnetic reson ance imaging is more sensitive in showing the intraorbital extension o f the leptomeningeal cyst. Frontobasal brain injury seems to play an i mportant role in the pathogenesis of the fracture growth. Craniotomy w ith direct repair of the dural and bone defects is the treatment of ch oice. CONCLUSION Growing fracture of the orbital roof may complicate m inor head injury and should be considered in the differentiated diagno sis in cases of persistent ocular symptoms. (C) 1997 by Elsevier Scien ce Inc.