Specific aspects of depressed skull fractures in childhood.

From 1971 to 1982, 35 children with a depressed skull fracture (d.s.f.) were observed. Their data are used to trace specific aspects of aetiopathogenesis, characteristics, clinical picture, treatment and prognosis of d.s.f. in childhood and to propose guidelines for treatment and follow-ups. The most important causes were falls and road accidents. Celluloid ball fractures were observed mainly in infants and green-stick fractures in toddlers and schoolchildren, and the clinical diagnosis was possible in 70%. Skull defects following surgery did not change their size beyond the age of 1 year and should be covered as soon as possible. The outcome of mild d.s.f. is good, in d.s.f. with contusion the outcome depends on the severity of brain trauma, mental retardation and/or posttraumatic epilepsy being the most important sequels. The latter and mild types of d.s.f. with early seizures, dural tear or residual skull defects need further follow-up; EEG recordings are of some interest.