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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does A Skull Fracture Of The Right Parietal Region Need Immediate Surgery?

My 8.5 month old son fell from our bed and suffered a depressed skull fracture to the right parietal region. The doctor wants to wait 6 months to determine if surgery is necessary. My son is learning to walk and I am terrifed of him hitting his head and making the fracture worse. What are the reasons for waiting? Isn't his skull almost finished growing?
Tue, 15 Dec 2015
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Neurologist, Surgical,  's  Response
Hello. Thanks for asking from HCM.


I can understand your concern. The depressed fracture is a type of fracture in which piece/pieces of bone dip below skull bone. It may or may not surgery. Surgery is needed for
: cosmetic reason like frontal bone
: depression along with bleed or dural tear ( membrane over brain ) and leakage of brain fluid (CSF)
: fracture over air sinuses
: open wound with fracture
: Fresh fracture (
In rest cases, depressed fracture may be managed by conservative management. Delayed surgery is required when fracture presents late, patient wants to wait, CSF leak.

In case of infants, management is observation if no bleed/CSF leak/open wound. Remodelling occurs in children which can correct skull shape. So do not worry. Most likely, your child had uncomplicated depressed fracture. The doctor is waiting and observing if any CSF leak occurs or cosmetically unacceptable shape remains, only then he may decide surgery.

His skull will develop mostly by 3 years.

Thanks. Hope it will help you. Take care.
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Does A Skull Fracture Of The Right Parietal Region Need Immediate Surgery?

Hello. Thanks for asking from HCM. I can understand your concern. The depressed fracture is a type of fracture in which piece/pieces of bone dip below skull bone. It may or may not surgery. Surgery is needed for : cosmetic reason like frontal bone : depression along with bleed or dural tear ( membrane over brain ) and leakage of brain fluid (CSF) : fracture over air sinuses : open wound with fracture : Fresh fracture ( In rest cases, depressed fracture may be managed by conservative management. Delayed surgery is required when fracture presents late, patient wants to wait, CSF leak. In case of infants, management is observation if no bleed/CSF leak/open wound. Remodelling occurs in children which can correct skull shape. So do not worry. Most likely, your child had uncomplicated depressed fracture. The doctor is waiting and observing if any CSF leak occurs or cosmetically unacceptable shape remains, only then he may decide surgery. His skull will develop mostly by 3 years. Thanks. Hope it will help you. Take care.