Skull Depression

September 14, 2005
Robert P. Blereau, MD

A 5-month-old boy's head hit the floor after he tumbled from his mother's arms. No injury was noted by the parents, and the infant immediately began to cry. His mother brought him to the emergency department just to be sure he was not seriously injured.

A 5-month-old boy's head hit the floor after he tumbled from his mother's arms. No injury was noted by the parents, and the infant immediately began to cry. His mother brought him to the emergency department just to be sure he was not seriously injured.

The asymptomatic child was alert and playful in the emergency department and had no seizures. A “ping-pong ball” depression was evident in the left parietal region. A skull indentation measuring 2.5 cm in diameter and 1.5 cm in depth was revealed in a tangential view roentgenogram. The CT scan disclosed no hematoma and no abnormality to the underlying brain.

Elevation of the depression was performed. Despite elevation of this type of skull fracture, post-traumatic epilepsy may develop. Injury to the underlying brain is thought to be the cause of this sequela.

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