Skull fracture (peds): Difference between revisions
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*Skull tenderness | *Skull tenderness | ||
*Skull depression or crepitus | *Skull depression or crepitus | ||
*Battle sign or raccoon eyes (basal skull fracture) | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 07:08, 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
- Battle sign or raccoon eyes (basal skull fracture)
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
- Consider antibiotics for:
- Open fracture
- Depressed fracture
- Sinus involvement
- 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.