Patients with fractures of the petrous temporal bone present with CSF otorrhea and bruising over the mastoids, ie, Battle sign.
Presentation with anterior cranial fossa fractures is with CSF rhinorrhea and bruising around the eyes, ie, "raccoon eyes." Loss of consciousness and Glasgow Coma Score may vary depending on an associated intracranial pathologic condition.
Longitudinal temporal bone fractures result in ossicular chain disruption and conductive deafness of greater than 30 d B that lasts longer than 6-7 weeks.
Skull fractures range from moderate to severe, but regardless of how minor the injury seems, immediate medical treatment is imperative.In many instances, a skull fracture occurs during a difficult delivery in which the baby is lodged in the mother’s pelvic area, is too large for normal delivery, and in some cases, too small for normal delivery.Vernet syndrome or jugular foramen syndrome is involvement of the IX, X, and XI cranial nerves with the fracture.Patients present with difficulty in phonation and aspiration and ipsilateral motor paralysis of the vocal cord, soft palate (curtain sign), superior pharyngeal constrictor, sternocleidomastoid, and trapezius.Infant skull fractures during birth or any other time, can leave devastating consequences that last a lifetime.
In fact, skull fractures remain the leading cause of both death and disabilities in children.
Awareness of the radiologist is essential in finding these skeletal and CNS injuries in order to document child abuse, to stop further abuse and to protect siblings.
by Simon Robben Battered child syndrome, shaken infant syndrome, stress-related infant abuse and non accidental trauma are all terms to describe the complex of non-accidental injuries in infants and young children as a result of abuse.
At least two thousand children die as a result of this abuse.
This overview focusses on the role of diagnostic imaging in depicting the findings that are specific for child abuse.
Sometimes a slight fracture can heal itself and should merely be monitored.