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Published in: Child's Nervous System 4/2024

29-12-2023 | Skull Fracture | Research

Treatment of depressed skull fractures with vacuum devices in the neonatal period: A case series

Authors: Sergio Cavalheiro, Mauricio D. Puch Ramírez, María Carolina Portela Fernández, Patricia Alessandra Dastoli, Marcos Devanir Silva da Costa

Published in: Child's Nervous System | Issue 4/2024

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Abstract

Purpose

The management of depressed skull fractures in infants can be either conservative or surgical. This study aimed to examine the outcomes of management with a negative-pressure vacuum device on depressed skull fractures in newborns.

Methods

Twenty-eight patients (aged 1–6 days) with simple depressed skull fractures underwent skull elevation using negative-pressure vacuum devices. A protocol for nonsurgical management was adopted for infants with such fractures between 2010 and 2023. All patients were initially evaluated with neurological examination and complementary assessments—hematological and coagulation studies, transfontanel transcranial ultrasound, skull radiography, and computed tomography scanning with three-dimensional reconstruction—according to availability and clinical needs. Gentle (negative) extraction pressure was applied with one of several devices (according to institutional availability) for a maximum duration of 60 s; this was performed as soon as possible after diagnosis, preferably within 72 h. Follow-up data, available in the clinical records, were reported.

Results

All patients exhibited satisfactory elevation of the depressed bone without associated injuries, except one patient who presented with an associated cephalohematoma which prevented optimal device coupling to generate sufficient vacuum pressure for correction. Neither neurological deficits nor development of epilepsy was noted; normal neurological assessment and oral alimentation tolerance were confirmed within 24 h post procedure.

Conclusions

According to our data, ping-pong skull fracture elevation using the vacuum method is a safe and satisfactory treatment in the neonatal period. Early treatment allows for quick resolution, and in our opinion is the strategy of choice for depressed skull fractures in newborns.
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Literature
20.
go back to reference Arocho-Quinones EV, Lew SM, Foy AB (2021) Vacuum-assisted elevation of pediatric ping-pong skull fractures: a case series and technical note. J Neurosurg Pediatr Marzo de 27(3):325–334CrossRef Arocho-Quinones EV, Lew SM, Foy AB (2021) Vacuum-assisted elevation of pediatric ping-pong skull fractures: a case series and technical note. J Neurosurg Pediatr Marzo de 27(3):325–334CrossRef
Metadata
Title
Treatment of depressed skull fractures with vacuum devices in the neonatal period: A case series
Authors
Sergio Cavalheiro
Mauricio D. Puch Ramírez
María Carolina Portela Fernández
Patricia Alessandra Dastoli
Marcos Devanir Silva da Costa
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 4/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-023-06261-z

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