Pediatrics in Review
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(Pediatrics in Review. 2000;21:210-214. doi:10.1542/10.1542/pir.21-6-210)
© 2000 American Academy of Pediatrics
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(Pediatrics in Review. 2000;21:210-214.)
© 2000 American Academy of Pediatrics

Visual Diagnosis: An Infant Who Has Head Trauma


Joseph A. Zenel, MD*
* Assistant Professor, Division of General Pediatrics, Doernbecher Children’s Hospital, Oregon Health Sciences University, Portland, OR.

   Presentation
 
A 2-month-old female is transferred to the hospital ward after presenting to an outlying emergency department with the chief complaint of head trauma and "swelling" of the right side of the head. A few hours earlier, her mother had accidentally dropped her out of an infant carrier onto a rug-covered wooden floor. The infant fell a distance of approximately 3 feet, hitting the right side of her head. She immediately cried and quickly recovered. Later she developed swelling of the right side of her head, prompting her mother to bring her to medical attention. The mother denies that her daughter is having any irritability, vomiting, lethargy, or breathing difficulties. When computed tomographic (CT) imaging of the head is interpreted to show a simple linear right parietal skull fracture with multiple intracranial hemorrhages of different ages, child protective services is notified, and the infant is transported to the hospital ward for further evaluation.

The infant was born at 36 weeks’ gestation via vaginal delivery to a 29-year-old mother. The neonatal course was complicated by respiratory distress, which required endotracheal intubation for ventilation and oxygenation, and a right intraventricular hemorrhage, diagnosed by head ultrasonography. Since then the infant has been healthy without any noticeable developmental delay. She lives with her parents. There are no siblings.

Physical examination reveals a quiet infant who has a soft, compressible, well-defined swelling over the right parietal region (Fig. . . . [Full Text of this Article]


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