{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T19:42:20Z","timestamp":1792352540597,"version":"4.4.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:sec id=\"S1\">\n                    <jats:title>\n                      <jats:italic>Object<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>The management regimen for depressed skull fractures in infants can be conservative or surgical. The aim of this study was to provide a rational principle of management for simple depressed skull fractures in infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2\">\n                    <jats:title>\n                      <jats:italic>Methods<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>A protocol of nonsurgical treatment for a simple depressed skull fracture was designed for all affected infants during the period from 1985 to 2001. Conservative management was used for those with a depressed fracture measuring less than 5 mm in depth, whereas vacuum extraction was applied for larger and deeper depressions. All of the patients were evaluated for initial results and later outcomes.<\/jats:p>\n                    <jats:p>\n                      Twenty-five infants suffering simple depressed skull fractures were consecutively enrolled. According to our protocol, 11 patients received conservative management by close observation only. Spontaneous restoration of the depression was observed in eight patients within a period of 1 to 6 months. For the remaining 14 patients, vacuum extraction was performed. A negative pressure of 0.3 to 0.8 kg\/cm\n                      <jats:sup>2<\/jats:sup>\n                      (mean 0.49 kg\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ) was applied for a duration of 20 to 90 seconds (mean 43.6 seconds). All but one patient experienced complete recovery following extraction. The depressions of the four patients that were residual after initial management smoothed out with time. No neurological deficit or later epilepsy was noted in any patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S3\">\n                    <jats:title>\n                      <jats:italic>Conclusions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Nonsurgical management can be the treatment of choice for infants with simple depressed skull fractures, whereas vacuum extraction is one option for larger and deeper depressions to obtain prompt resolution and relieve major family anxiety, without taking additional risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/ped.2005.103.1.0069","type":"journal-article","created":{"date-parts":[[2010,8,27]],"date-time":"2010-08-27T06:01:30Z","timestamp":1282888890000},"page":"69-72","source":"Crossref","is-referenced-by-count":18,"title":["Rational management of simple depressed skull fractures in infants"],"prefix":"10.3171","volume":"103","author":[{"given":"Kun-Long","family":"Hung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Tsai","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Shan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/0028-2243(86)90073-0","article-title":"Congenital depression of the neonatal skull.","volume":"22","author":"Ben-Ari","year":"1986"},{"key":"b2","series-title":"S Afr Med J","first-page":"830","article-title":"Depressed skull fracture in the newborn. A report of 3 cases.","volume":"54","author":"Beyers","year":"1978"},{"key":"b3","series-title":"J Reprod Med","first-page":"321","article-title":"Intrauterine spontaneous depression of fetal skull: a case report and review of literature.","volume":"16","author":"Guha-Ray","year":"1976"},{"key":"b4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"208","DOI":"10.3171\/jns.1974.41.2.0208","article-title":"Epilepsy after nonmissile depressed skull fracture.","volume":"41","author":"Jennett","year":"1974"},{"key":"b5","series-title":"Br Med J","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1136\/bmj.3.5882.698-a","article-title":"Letter: Depressed fracture in the newborn.","volume":"3","author":"Kyle","year":"1973"},{"key":"b6","series-title":"Asia Oceania J Obstet Gynaecol","first-page":"227","article-title":"Depressed skull fracture in a newborn successfully managed conservatively: a case report.","volume":"17","author":"Lim","year":"1991"},{"key":"b7","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3171\/jns.1976.44.1.0062","article-title":"Management of depressed skull fracture in the newborn.","volume":"44","author":"Loeser","year":"1976"},{"key":"b8","series-title":"Neurosurgery of Infancy and Childhood","first-page":"934","author":"Matson","year":"1969"},{"key":"b9","series-title":"Lancet","first-page":"991","article-title":"Complications of depressed skull fracture.","volume":"2","author":"Miller","year":"1968"},{"key":"b10","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1542\/peds.51.2.169","article-title":"The fate of children sustaining severe head trauma during birth.","volume":"51","author":"Natelson","year":"1973"},{"key":"b11","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1097\/00005373-199111000-00017","article-title":"Closed depressed skull fracture in childhood reduced with suction cup method: case report.","volume":"31","author":"Paul","year":"1991"},{"key":"b12","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/S0022-3476(68)80321-X","article-title":"Nonsurgical elevation of depressed skull fracture in an infant.","volume":"72","author":"Raynor","year":"1968"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"726","DOI":"10.3171\/jns.1975.42.6.0726","article-title":"Spontaneous elevation of a depressed skull fracture in an infant. Case report.","volume":"42","author":"Ross","year":"1975"},{"key":"b14","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"512","DOI":"10.3171\/jns.1979.50.4.0512","article-title":"Depressed skull fracture in the neonate. Report of three cases.","volume":"50","author":"Saunders","year":"1979"},{"key":"b15","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/S0022-3476(70)80340-7","article-title":"Elevation of depressed skull fracture with a breast pump.","volume":"77","author":"Schrager","year":"1970"},{"key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"506","DOI":"10.3171\/jns.1987.66.4.0506","article-title":"Management of simple depressed skull fractures in children.","volume":"66","author":"Steinbok","year":"1987"},{"key":"b17","series-title":"Obstet Gynecol Surv","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/00006254-199005000-00002","article-title":"Congenital depression of the fetal skull.","volume":"45","author":"Strong","year":"1990"},{"key":"b18","series-title":"Acta Paediatr Scand","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1111\/j.1651-2227.1974.tb04847.x","article-title":"Elevation of congenital depressed fractures of the skull by the vacuum extractor.","volume":"63","author":"Tan","year":"1974"},{"key":"b19","series-title":"Br Med J","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1136\/bmj.2.5809.353-b","article-title":"Reduction of pond fracture.","volume":"2","author":"Van Enk","year":"1972"},{"key":"b20","series-title":"Taiwan Yi Xue Hui Za Zhi","first-page":"270","article-title":"[A case report of depressed skull fracture of the newborn treated with a vacuum extractor.]","volume":"84","author":"Wu","year":"1985"},{"key":"b1","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/0028-2243(86)90073-0","article-title":"Congenital depression of the neonatal skull.","volume":"22","author":"Ben-Ari","year":"1986"},{"key":"b2","series-title":"S Afr Med J","first-page":"830","article-title":"Depressed skull fracture in the newborn. 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