Skull perforation and depressed fracture following skull fixation for streotactic surgery

Abstract

We report an unusual case of skull perforation and depressed fracture with epidural hematoma in a 61-year-old woman who has been undertaken a skeletal fixation for stereotactic evacuation of intracerebral hematoma. Most neurosurgeons secure the patient's head in a skeletal fixation device with a three- or four-pronged pin-type headrest for stereotactic procedure or microsurgery. Although a variety of complications have been reported secondary to the use of head fixation devices, these potential complications of skull fixation have been infrequently described in the medical literatures. Consideration of calvarial thickness, tightening force, and adequate location of skull fixation may reduce the risk of skull perforation and depressed fracture.