Skull fracture (peds)
Background
- Predictor of intracranial injury
- Infants are at higher risk due to thinner calvarium
- Most skull fractures have overlying hematoma
Clinical Features
Differential Diagnosis
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Evaluation
- Head CT
Management
- Antibiotics indicated for:
- Open fracture
- Depressed fracture
- Involves sinus
- Leads to pneumocephalus
- Ceftriaxone 2gm IV + metronidazole 500mg +/- vancomycin 1gm IV
Disposition
Likely safe discharge if[1]:
- Neurologically normal
- Isolated linear skull fracture
- No concern for child abuse
- No concern for child abuse
- Isolated linear skull fracture
Admit others
See Also
- Head Trauma
- Skull fracture (Adult)
External Links
References
- ↑ Bressan, S., Marchetto, L., Lyons, T. W., Monuteaux, M. C., Freedman, S. B., Da Dalt, L., & Nigrovic, L. E. (2018). A Systematic Review and Meta-Analysis of the Management and Outcomes of Isolated Skull Fractures in Children. Annals of Emergency Medicine, 71(6), 714–724.e2.