Skull fracture (peds)

Background

• Predictor of intracranial injury
• Infants are at higher risk due to thinner calvarium
• Most skull fractures have overlying hematoma

Differential Diagnosis

Maxillofacial Trauma

• Ears
  • Auricular hematoma
• Nose
  • Nasal fracture
  • Nasal septal hematoma
• Oral
  • Dental trauma
  • Lip laceration
  • Tongue laceration
• Other face
  • Le Fort fractures
  • Mandible fracture
• Zygomatic arch fracture
• Zygomaticomaxillary (tripod) fracture
• Related
  • Head trauma (main)
    • Skull fracture
    • Skull fracture (peds)
    • Basilar skull fracture
  • Orbital trauma
    • Eyelid laceration
  • Scalp laceration

Evaluation

• Head CT

Management

• Antibiotics indicated for:
  • Open fracture
  • Depressed fracture
  • Involves sinus
  • Leads to pneumocephalus
• Ceftriaxone 2gm IV + metronidazole 500mg +/- vancomycin 1gm IV

See Also

• Head Trauma