The remarkably rapid rate of growth of the infant brain challenges all physicians to protect it in the first year of life. Dural laceration associated with a separation skull fracture is not an unusual occurrence in childhood. However, when this injury is associated with unrecognized craniostenosis the course of the disease and its management present interesting problems and emphasize the importance of aggressive treatment planned to allow maximum brain expansion.
Craniostenosis is an unusual anomaly in which the cranial sutures close prematurely, restricting growth of the intracranial contents and causing distortion of the normal development of the skull. Skull expansion is limited by premature suture fusion and progresses most rapidly in the direction allowed by the suture lines which remain open. Scaphocephaly, the commonest variation, is produced by early closure of the sagittal suture and leads to anteroposterior lengthening of the cranium. Brachycephaly (acrocephaly), with increased transverse diameter of the