Growing burr hole: enlarging pseudomeningocele at the site of a craniostomy

Background. Growing skull fractures and other enlarging skull defects are rare postoperative occurrences. We report here on a 10-month-old girl who presented with an enlarging burr hole and pseudomeningocele after an endoscopic third ventriculocisternostomy. Methods. Evaluation of an enlarging subcutaneous mass at the site of the burr hole included computed tomography scans and magnetic resonance imaging, which revealed a pseudomeningocele. The patient underwent repair of the lesion, including dural closure and cranioplasty. Conclusions. Growing skull fractures or other enlarging bone defects may occur after burr hole placement, particularly in infants who require larger access sites for endoscopy.