Identifying skull fractures after head trauma in infants with ultrasonography: is that possible?

Management of pediatric head trauma requires a delicate balance between accuracy and safety, with a dual emphasis on prompt diagnosis while minimizing radiation exposure. Ultrasonography (US) shows promise in this regard. A case study involving a 10-month-old infant with acute right parietal swellin...

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Bibliographic Details
Published inJournal of ultrasound
Main Authors Filice, Riccardo, Miselli, Francesca, Guidotti, Isotta, Lugli, Licia, Palazzi, Giovanni, Berardi, Alberto, Iughetti, Lorenzo
Format Journal Article
LanguageEnglish
Published Italy 27.06.2024
Subjects
Skull fracture
Children
Head trauma
Pediatric
Ultrasound
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Summary:Management of pediatric head trauma requires a delicate balance between accuracy and safety, with a dual emphasis on prompt diagnosis while minimizing radiation exposure. Ultrasonography (US) shows promise in this regard. A case study involving a 10-month-old infant with acute right parietal swelling revealed the utility of US in detecting a corresponding hypoechoic lesion, along with an underlying suspected fracture line of the vault and subdural hematoma. Subsequent CT confirmed the fracture, while MRI confirmed the subdural hematoma. At one-month follow-up, MRI demonstrated hematoma reabsorption, while US revealed a bone callus in its advanced phase. Although US is not yet standard practice for pediatric head trauma, its ability to detect fractures in infants suggests its potential role: when a fracture is evident on US, it may serve as an indication to perform neuroimaging. Potentially, adoption of US could contribute to mitigation of children's exposure to ionizing radiation.
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ISSN:1876-7931
1876-7931
DOI:10.1007/s40477-024-00907-7