Skull fracture (peds): Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
* | *Scalp hematoma | ||
*Skull tenderness | |||
*Skull depression or crepitus | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 20: | Line 22: | ||
**Involves sinus | **Involves sinus | ||
**Leads to pneumocephalus | **Leads to pneumocephalus | ||
*[[Ceftriaxone]] | *[[Ceftriaxone]] '''AND''' [[metronidazole]] +/- [[vancomycin]] | ||
==Disposition== | ==Disposition== | ||
*Consider discharge if<ref>Bressan, S., Marchetto, L., Lyons, T. W., Monuteaux, M. C., Freedman, S. B., Da Dalt, L., & Nigrovic, L. E. (2018). A Systematic Review and Meta-Analysis of the Management and Outcomes of Isolated Skull Fractures in Children. Annals of Emergency Medicine, 71(6), 714–724.e2.</ref>: | |||
*Neurologically normal | **Neurologically normal | ||
**Isolated linear skull fracture | **Isolated closed linear skull fracture | ||
**No concern for [[non-accidental trauma]] | |||
Admit others | *Admit all others | ||
==See Also== | ==See Also== | ||
Revision as of 06:54, 8 February 2019
Background
- Predictor of intracranial injury
- Infants are at higher risk due to thinner calvarium
- Most skull fractures have overlying hematoma
Clinical Features
- Scalp hematoma
- Skull tenderness
- Skull depression or crepitus
Differential Diagnosis
Head trauma
- Traumatic brain injury
- Intracranial hemorrhage
- Intra-axial
- Extra-axial
- Moderate-to-severe traumatic brain injury
- Mild traumatic brain injury
- Intracranial hemorrhage
- Orbital trauma
- Maxillofacial trauma
- Scalp laceration
- Skull fracture
- Pediatric head trauma
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Evaluation
- Head CT
Management
- Antibiotics indicated for:
- Open fracture
- Depressed fracture
- Involves sinus
- Leads to pneumocephalus
- Ceftriaxone AND metronidazole +/- vancomycin
Disposition
- Consider discharge if[1]:
- Neurologically normal
- Isolated closed linear skull fracture
- No concern for non-accidental trauma
- Admit all others
See Also
- Head Trauma
- Skull fracture (Adult)
External Links
References
- ↑ Bressan, S., Marchetto, L., Lyons, T. W., Monuteaux, M. C., Freedman, S. B., Da Dalt, L., & Nigrovic, L. E. (2018). A Systematic Review and Meta-Analysis of the Management and Outcomes of Isolated Skull Fractures in Children. Annals of Emergency Medicine, 71(6), 714–724.e2.