Skull fracture (peds)

This page is for pediatric patients; for adult patients see skull fracture

Background

Bones of the cranium.
  • Predictor of intracranial injury
  • Infants are at higher risk due to thinner calvarium (median age for isolated skull fracture is 10 months)[1]
  • Most skull fractures have overlying hematoma

Clinical Features

  • Scalp hematoma
  • Skull tenderness
  • Skull depression or crepitus
  • Battle sign or raccoon eyes (basal skull fracture)
  • Loss of consciousness, nausea/vomiting, altered mental status (less common in younger children than other children and adults with isolated skull fracture)[1]

Differential Diagnosis

Head trauma

Maxillofacial Trauma

Evaluation

  • Head CT

Management

Disposition

  • Consider discharge if[2][1]:
  • Admit all others

See Also

External Links

References

  1. 1.0 1.1 1.2 Elizabeth C. Powell, et al. Isolated Linear Skull Fractures in Children With Blunt Head Trauma. Pediatrics Apr 2015, 135 (4) e851-e857; DOI: 10.1542/peds.2014-2858
  2. 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.