Depressed skull fracture dating
A typical skeletal survey comprises plain films of the following: The ability to date injuries is critical for medicolegal purposes, and thus must be done carefully (please refer to specialist text for specific guidelines). Metaphyseal (and costochondral junction) injuries do not heal with periosteal reaction and if visible are less than 4 weeks old.Traumatic periosteal injury can be seen up to 7 days post injury (and therefore can be used for dating). Skull fractures also do not heal with periosteal reaction and if seen are less than 2 weeks old.Correspondence Address: Jui Chang Tsai Department of Surgery, Division of Neurosurgery, National Taiwan University Hospital, National Taiwan University College of Medicine, No. Rd., Zhongzheng Dist., Taipei City 100, Taiwan Republic of China Source of Support: None, Conflict of Interest: None A head fixation device with pins is commonly used for immobilization of the patient's head during craniotomy.The safety of head fixation devices in children has been discussed rarely in the literature.Figure 1: (a) Brain magnetic resonance imaging scans revealed a posterior fossa mass.(b and c) A postoperative emergent computed tomography scan revealed a large right sided epidural hematoma (long arrow) with depressed fracture of the temporal bone (short arrow), where the pin had been placed the age range was from 2 years and 7 months to 6 years and 6 months.A subdural hemorrhage in a child should be viewed with suspicion.
Radiologists are often the first to suspect NAI when confronted with particular injury patterns, and a knowledge of these is essential if the opportunity to save a child from future neglect is not to be missed.J Med Sci [serial online] 2014 [cited 2017 Nov 8];8-40. 2014/34/5/238/143654 It is common knowledge among neurosurgeons that head pin fixation devices can cause skull fracture or perforation resulting in an epidural bleeding.