All issues > Volume 43(4); 2000

Case Report

J Korean Pediatr Soc. 2000;43(4):567-572. Published online April 15, 2000.

Four Cases of Congenital Depressed Skull Fractures in Neonates

Byung Soon BS Kang¹, Eun Young EY Kim¹, Chang Weon CW Oh¹, Kyoung Sim KS Kim¹, Yong Wook YW Kim¹, Min Suk MS Oh²

¹Department of Pediatrics, Kwangju Christian Hospital, Kwangju, Korea
²Department of Neurosurgery, Kwangju Christian Hospital, Kwangju, Korea

Abstract

Depressed skull fractures in newborn babies mainly result from birth injury and rarely occurr in intrauterine life without any definable etiology. We present 4 cases of congenital intrauterine depressed skull fractures which were discovered at birth in neonates. Three babies(case 1, 2, 3) had round shallow depressions without adjacent soft tissue injury except the last one(case 4), showing sharp angulation in the center of the depression. They had neither birth trauma nor forceps applications and they were healthy without neurologic symptoms. We performed nonsurgical reduction using vacuum extractor in all cases. Three cases were reduced successfully, but the last one failed due to sharp angulation in the center of the depression. It was reduced successfully by surgical elevation using a Freer elevator. Reduction should be performed in congenital depressed skull fractures without neurologic symptoms, because brain compression by depressed fracture results in brain injury or epileptic focus. Nonsurgical reduction should be prior to surgical reduction because of its technical feasability, safety and good results, but surgical reduction should be attempted in the case of sharp angulation in the center of the depression.

Keywords :Congenital depressed skull fracture, Angulation, Surgical reduction