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Published on: June 10, 2020
Traumatic nondisplaced coronal suture fracture causing delayed intracranial hemorrhage in a pediatric patient
1Sanford Brain and Spine Center, Sanford Children's Hospital, Fargo, North Dakota.
Insights
Pediatric skull fractures, particularly coronal suture fractures, can mask serious intracranial injuries like delayed hemorrhage. Vigilance is crucial when assessing head trauma in young children to ensure timely diagnosis and treatment.
Area of Science:
- Pediatric Traumatology
- Neuroimaging
- Neurosurgery
Background:
- Skull fractures are common in children under two years old following head injuries.
- Isolated pediatric skull fractures often have a benign prognosis and may not require hospitalization.
Observation:
- A case report details a 14-month-old girl with a unilateral, nondisplaced coronal suture fracture from a fall.
- The patient subsequently developed delayed intracranial hemorrhage due to an underlying dural tear and cortical vein injury.
Findings:
- Nondisplaced fractures across the coronal suture in pediatric patients can be associated with dural tears and intracranial injuries.
- Delayed intracranial hemorrhage is a potential complication of seemingly minor skull fractures in this age group.
Implications:
- High vigilance is required when interpreting CT scans of pediatric head trauma, especially around suture lines.
- Coronal suture fractures in children warrant careful evaluation for associated intracranial pathology, even if nondisplaced.
Abstract:
Skull fracture after a head injury is relatively common in children younger than 2 years of age. The author reports the case of a 14-month-old girl who sustained a unilateral nondisplaced coronal suture fracture from a fall. She developed delayed intracranial hemorrhage from an underlying dural tear and cortical vein injury. Although an isolated skull fracture in a pediatric trauma patient typically portends a benign clinical course and may not require that the patient be hospitalized, a nondisplaced fracture across the coronal suture can lead to dural tear and intracranial injuries. High vigilance is warranted when evaluating CT images around the suture lines and treating pediatric patients with fractures across the coronal suture.
