Traumatic diastasis of the lambdoid suture

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Skateboard injury. Hit head, now profuse bleeding from right external auditory meatus

Patient Data

Age: 12 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Scalp hematoma with underlying right lambdoid suture diastasis extending as a fracture into the right petrous temporal bone (mastoid air cells) leading to the accumulation of subdural gas underlying the diastasis. 

Fracture through the mastoid air cells is so-called longitudinal in orientation (i.e. in the long axis of the petrous ridge) and enters the middle ear cleft leading to fluid (blood) accumulation. 

The tympanic membrane is perforated, allowing this blood to leak into the external auditory canal.

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