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Child's Nervous System
Published in: Child's Nervous System 6/2017

01-06-2017 | Case-Based Update

Infantile cranial fasciitis: case-based review and operative technique

Authors: Oliver E. Flouty, Anthony J. Piscopo, Marshall T. Holland, Kingsley Abode-Iyamah, Leslie Bruch, Arnold H. Menezes, Brian J. Dlouhy

Published in: Child's Nervous System | Issue 6/2017

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Abstract

Background

Cranial fasciitis (CF) is an uncommon benign primary lesion of the skull that typically affects the pediatric age group. Due to the rarity of CF, no prospective studies exist. Earliest description of this condition dates to 1980. The limited scientific and clinical literature regarding CF is dominated by case reports. For these reasons, questions pertaining to the true incidence, genetic risk factors, prognosis, and long-term outcome remain unanswered.

Discussion

Clinically, CF presents as a firm, painless, growing scalp mass that is typically not considered in the differential diagnosis. Preoperative pathognomonic signs and symptoms are absent, and imaging features are often nonspecific. Treatment is typically through complete surgical resection, at which time histopathological examination confirms the diagnosis of CF. Reconstruction of the skull defect in the child is critical. Autograft techniques help maintain a rigid construct that integrates with the native skull while preserving its continued ability to grow. Generally, a good outcome is observed with complete resection.

Exemplary case

We report a case of CF in an infant with emphasis on operative nuances and early follow-up results.

Conclusion

CF is a rare fibroproliferative disease that has a poorly defined incidence and long-term follow-up. Due to its locally invasive nature and nonspecific presentation, CF is often difficult to differentiate from malignancies and infections. Complete surgical resection is the best approach for diagnosis and cure. Its occult clinical presentation often allows it to achieve considerable growth, leaving a sizeable skull defect following resection. Since CF presents in the pediatric population, allograft reconstruction is preferred over titanium mesh or other synthetic materials to allow osseous integration and continued uninterrupted skull growth.
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Metadata
Title
Infantile cranial fasciitis: case-based review and operative technique
Authors
Oliver E. Flouty
Anthony J. Piscopo
Marshall T. Holland
Kingsley Abode-Iyamah
Leslie Bruch
Arnold H. Menezes
Brian J. Dlouhy
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 6/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3417-y

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