Skull fracture (peds) - Revision history

Ostermayer at 17:14, 17 January 2026

2026-01-17T17:14:38Z

← Older revision		Revision as of 17:14, 17 January 2026
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	{{~~Peds top~~}} ~~[[skull fracture]].''~~		{{PediatricPage\|skull fracture}}
	==Background==		==Background==
	[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]		[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]

Rossdonaldson1 at 20:50, 11 November 2020

2020-11-11T20:50:04Z

← Older revision		Revision as of 20:50, 11 November 2020
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	~~''This page is for <u>pediatric</u> patients; for adult patients see~~ [[skull fracture]]''		{{Peds top}} [[skull fracture]].''
	==Background==		==Background==
	[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]		[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]

ClaireLewis at 15:40, 3 October 2019

2019-10-03T15:40:30Z

← Older revision		Revision as of 15:40, 3 October 2019
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	*Skull tenderness		*Skull tenderness
	*Skull depression or crepitus		*Skull depression or crepitus
	*Battle sign or raccoon eyes (~~basal~~ skull fracture)		*Battle sign or raccoon eyes ([[basilar skull fracture]])
	*Loss of consciousness, nausea/vomiting, altered mental status (less common in younger children than other children and adults with isolated skull fracture)<ref name="Powell" />		*Loss of consciousness, [[nausea and vomiting (peds)\|nausea/vomiting]], [[altered mental status (peds)\|altered mental status]] (less common in younger children than other children and adults with isolated skull fracture)<ref name="Powell" />

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*Head CT		*[[Head CT]]
			*Evaluate for additional injuries

	==Management==		==Management==

Rossdonaldson1 at 21:11, 18 July 2019

2019-07-18T21:11:34Z

← Older revision		Revision as of 21:11, 18 July 2019
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			''This page is for <u>pediatric</u> patients; for adult patients see [[skull fracture]]''
	==Background==		==Background==
	[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]		[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]

Rossdonaldson1: /* Background */

2019-07-18T21:10:19Z

Background

← Older revision		Revision as of 21:10, 18 July 2019
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	==Background==		==Background==
			[[File:Cranial bones en.png\|thumb\|Bones of the cranium.]]
	*Predictor of intracranial injury		*Predictor of intracranial injury
	*Infants are at higher risk due to thinner calvarium (median age for isolated skull fracture is 10 months)<ref name="Powell">Elizabeth C. Powell, et al. Isolated Linear Skull Fractures in Children With Blunt Head Trauma. Pediatrics Apr 2015, 135 (4) e851-e857; DOI: 10.1542/peds.2014-2858</ref>		*Infants are at higher risk due to thinner calvarium (median age for isolated skull fracture is 10 months)<ref name="Powell">Elizabeth C. Powell, et al. Isolated Linear Skull Fractures in Children With Blunt Head Trauma. Pediatrics Apr 2015, 135 (4) e851-e857; DOI: 10.1542/peds.2014-2858</ref>

Mholtz at 07:34, 8 February 2019

2019-02-08T07:34:40Z

← Older revision		Revision as of 07:34, 8 February 2019
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	==Background==		==Background==
	*Predictor of intracranial injury		*Predictor of intracranial injury
	*Infants are at higher risk due to thinner calvarium		*Infants are at higher risk due to thinner calvarium (median age for isolated skull fracture is 10 months)<ref name="Powell">Elizabeth C. Powell, et al. Isolated Linear Skull Fractures in Children With Blunt Head Trauma. Pediatrics Apr 2015, 135 (4) e851-e857; DOI: 10.1542/peds.2014-2858</ref>
	*Most skull fractures have overlying hematoma		*Most skull fractures have overlying hematoma

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	*Skull depression or crepitus		*Skull depression or crepitus
	*Battle sign or raccoon eyes (basal skull fracture)		*Battle sign or raccoon eyes (basal skull fracture)
			*Loss of consciousness, nausea/vomiting, altered mental status (less common in younger children than other children and adults with isolated skull fracture)<ref name="Powell" />

	==Differential Diagnosis==		==Differential Diagnosis==
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	==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>:		*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><ref name="Powell" />:
	**Neurologically normal		**Neurologically normal
	**Isolated closed linear skull fracture		**Isolated closed linear skull fracture

Mholtz at 07:08, 8 February 2019

2019-02-08T07:08:35Z

← Older revision		Revision as of 07:08, 8 February 2019
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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==

Mholtz at 06:55, 8 February 2019

2019-02-08T06:55:37Z

← Older revision		Revision as of 06:55, 8 February 2019
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	==Management==		==Management==
	*~~Antibiotics indicated~~ for:		*Consider antibiotics for:
	**Open fracture		**Open fracture
	**Depressed fracture		**Depressed fracture
	**~~Involves sinus~~		**Sinus involvement
	**~~Leads to pneumocephalus~~		**Pneumocephalus
	*[[Ceftriaxone]] '''AND''' [[metronidazole]] +/- [[vancomycin]]		*[[Ceftriaxone]] '''AND''' [[metronidazole]] +/- [[vancomycin]]

Mholtz at 06:54, 8 February 2019

2019-02-08T06:54:39Z

← Older revision		Revision as of 06:54, 8 February 2019
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	==Clinical Features==		==Clinical Features==
	*		*Scalp hematoma
			*Skull tenderness
			*Skull depression or crepitus

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Involves sinus		**Involves sinus
	**Leads to pneumocephalus		**Leads to pneumocephalus
	*[[Ceftriaxone]] ~~2gm IV +~~ [[metronidazole]] ~~500mg~~ +/- [[vancomycin]] ~~1gm IV~~		*[[Ceftriaxone]] '''AND''' [[metronidazole]] +/- [[vancomycin]]

	==Disposition==		==Disposition==
	~~Likely safe~~ 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>:		*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 ~~child abuse<br />~~		**No concern for [[non-accidental trauma]]
	Admit others		*Admit all others

	==See Also==		==See Also==

Rossdonaldson1: /* Differential Diagnosis */

2018-11-25T19:19:46Z

Differential Diagnosis

← Older revision		Revision as of 19:19, 25 November 2018
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Head trauma DDX}}
	{{Maxillofacial trauma DDX}}		{{Maxillofacial trauma DDX}}