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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