Infantile head trauma with orbital roof fracture
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Right parietal scalp swelling. Complex fractures of the right and left parietal bones. Bilateral vertex subdural hemorrhage. Loss of supratentorial gray/white differentiation. Right orbital roof fracture.
Bone window view of the right orbital roof fracture, right and left parietal fractures.
History: 2-month-old, former 33 week premature with no neonatal complications.
Exam: unresponsive, boggy right parietal scalp
Skeletal survey: (not shown) bilateral healing rib fractures
Tragically this child died from malignant brain swelling after 4 days in the hospital. The right orbital fracture was found at autopsy. The presumed diagnosis was abusive head trauma.
- 1. Alcalá-Galiano A, Arribas-García IJ, Martín-Pérez MA, Romance A, Montalvo-Moreno JJ, Juncos JM. Pediatric facial fractures: children are not just small adults. Radiographics: a review publication of the Radiological Society of North America, Inc. 28 (2): 441-61; quiz 618. doi:10.1148/rg.282075060 - Pubmed