A Pediatric Radiology textbook and Pediatric Radiology digital library
Skull Fracture
Etiology: trauma
Imaging: — Linear – simple fracture with the skull fragments closely approximated — Diastatic – complex fracture with the skull fragments spread apart — Depressed – complex fracture with the skull fragments entering into the cranium — Ping Pong – etiology is depression of plastic fetal skull against maternal sacral promontory or forceps, usually no intracranial injury, clinically spontaneously resolve — Growing (leptomeningeal cyst) – etiology is following diastatic fracture, dura is interrupted and there is erosion of fracture edges due to CSF pulsation, clinically is unique to infants less than 3 years old, — Healing – skull fracture, which involve membranous bone, heals without periosteal reaction and slowly disappears
Cases of Skull Fracture
Lateral radiograph of the skull shows bilateral linear parietal lucencies coursing across the skull.3D reconstruction from a CT without contrast of the brain shows a wide right parietal lucency between two separated fragments of bone.
Axial CT without contrast of the brain shows depression of the skull in the left temperoparietal region with an associated subgaleal hematoma containing subcutaneous air.3D CT reconstruction initially (left) showed a diastatic skull fracture which has increased in size on the lateral radiograph of the skull (right) taken 2 months later.3D reconstruction from CT without contrast of the brain (left) shows a linear straight lucency that connects to the left lambdoid suture. Coronal CT (right) shows the same linear lucency lying under a large subgaleal hematoma.Lateral radiograph of the skull initially (left) showed bilateral linear parietal lucencies coursing across the skull which are no longer seen 4 months later (right).
