Skull fracture (NAI)
Skull fracture in non-accidental injury is the result of abusive impact head trauma. However, skull fractures do occur in children as the result of accidental head injury and it is important for the radiologist to understand what features make a non-accidental etiology more likely.
Parietal skull fractures are the commonest type of fracture in children. A simple parietal skull fracture is no more likely to be non-accidental than accidental. If the history fits the injury and there is no evidence of other injuries or social concerns, it is unlikely that further child-protection workup is required.
Simple skull fractures are single, linear fractures with no depression and no sutural diastasis.
In cases where there are stellate, complex or depressed fractures, or where there is sutural diastasis, there is an increased likelihood that the injury is the result of an inflicted non-accidental injury (abusive head trauma).