Infantile head trauma with orbital roof fracture

Case contributed by Joseph Scheller


Unresponsive infant

Patient Data

Age: 2 months

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.

Case Discussion

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

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