Rupture or traumatic dislocation of cranial suture on infants, involvement of the lambdoidal accessory bones (Wormian bones): case presentation and analysis.
Childs Nerv Syst
; 35(11): 2233-2236, 2019 11.
Article
in En
| MEDLINE
| ID: mdl-31037423
ABSTRACT
BACKGROUND:
Sutural or Wormian bones are accessory bones of genetic and hereditary relevance, considered as ethnic and anatomical variables. Recently, they have been related to a certain type of congenital alterations such as osteogenesis imperfecta; however, there is no description in the literature of their involvement in skull fractures in infants. CASE PRESENTATION We present a case of a male patient aged 15 months who suffered a fall from the stairs of his home approximately 6 h before arrival in the emergency room. This fall of approximately 1 m in height and with an area of direct impact on the right occipito-parietal region with no apparent loss of consciousness. At admission, with a Glasgow of 14 for irritability with subgaleal hematoma and cranial endostosis on occipitoparietal region, no more neurological signs were present. A CT scan of the skull was performed showing an occipital-parietal discontinuity at the lambdoid suture, and the scan also showed that a displacement occurred below the thickness of the adjacent bone. In addition, radiographic evidence showed a high possibility of dural penetration and an area of adjacent hemorrhagic contusion. Due to these findings, a surgical approach was decided upon. The findings in the surgical procedure were a complete dislocation (rupture) of lambdoidal cranial suture on the occipital border of the accessory bone (Wormian bone) with dura mater tear on the rupture tracing. A craniotomy was performed with dural plasty without eventualities. Forty-eight hours after surgery, he was discharged home in a stable neurologic condition.CONCLUSIONS:
The present report shows the implications of approaching this type of injury, which can be confused as a depressed skull fracture. There is no description in the literature of a sutural rupture associated with Wormian bones.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parietal Bone
/
Rupture
/
Cranial Sutures
/
Skull Fracture, Depressed
/
Joint Dislocations
/
Dura Mater
/
Occipital Bone
Type of study:
Diagnostic_studies
Limits:
Humans
/
Infant
/
Male
Language:
En
Journal:
Childs Nerv Syst
Journal subject:
NEUROLOGIA
/
PEDIATRIA
Year:
2019
Document type:
Article