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Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case
BACKGROUND: After being struck in the left side of the head by a thin metal rod, a 10-year-old, previously healthy male presented to an urgent care clinic with a subcentimeter scalp laceration in the midline parietal area and a normal neurological exam. Evaluation included skull radiographs, which d...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Association of Neurological Surgeons
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10550710/ https://www.ncbi.nlm.nih.gov/pubmed/36718869 http://dx.doi.org/10.3171/CASE22386 |
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author | Gruber, Maxwell Klingele, Nate Monson, Christy Sribnick, Eric A. |
author_facet | Gruber, Maxwell Klingele, Nate Monson, Christy Sribnick, Eric A. |
author_sort | Gruber, Maxwell |
collection | PubMed |
description | BACKGROUND: After being struck in the left side of the head by a thin metal rod, a 10-year-old, previously healthy male presented to an urgent care clinic with a subcentimeter scalp laceration in the midline parietal area and a normal neurological exam. Evaluation included skull radiographs, which did not demonstrate a definitive fracture. Following laceration repair, the patient was discharged to home. OBSERVATIONS: Subsequently, progressive neurological symptoms prompted his family to bring him back for evaluation 2 days later, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed an open, depressed skull fracture. Surgical intervention was performed with debridement and closure. The patient was placed on a course of intravenous antibiotics and had no subsequent evidence of infection. LESSONS: In cases involving potential cranial perforation by a thin projectile, use of CT imaging or MRI, rather than plain radiographs, may prevent a delay in diagnosis and subsequent complications. |
format | Online Article Text |
id | pubmed-10550710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Association of Neurological Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-105507102023-10-06 Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case Gruber, Maxwell Klingele, Nate Monson, Christy Sribnick, Eric A. J Neurosurg Case Lessons Case Lesson BACKGROUND: After being struck in the left side of the head by a thin metal rod, a 10-year-old, previously healthy male presented to an urgent care clinic with a subcentimeter scalp laceration in the midline parietal area and a normal neurological exam. Evaluation included skull radiographs, which did not demonstrate a definitive fracture. Following laceration repair, the patient was discharged to home. OBSERVATIONS: Subsequently, progressive neurological symptoms prompted his family to bring him back for evaluation 2 days later, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed an open, depressed skull fracture. Surgical intervention was performed with debridement and closure. The patient was placed on a course of intravenous antibiotics and had no subsequent evidence of infection. LESSONS: In cases involving potential cranial perforation by a thin projectile, use of CT imaging or MRI, rather than plain radiographs, may prevent a delay in diagnosis and subsequent complications. American Association of Neurological Surgeons 2023-01-30 /pmc/articles/PMC10550710/ /pubmed/36718869 http://dx.doi.org/10.3171/CASE22386 Text en © 2023 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ). |
spellingShingle | Case Lesson Gruber, Maxwell Klingele, Nate Monson, Christy Sribnick, Eric A. Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
title | Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
title_full | Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
title_fullStr | Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
title_full_unstemmed | Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
title_short | Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
title_sort | occult pediatric skull fracture and implications for delay in diagnosis: illustrative case |
topic | Case Lesson |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10550710/ https://www.ncbi.nlm.nih.gov/pubmed/36718869 http://dx.doi.org/10.3171/CASE22386 |
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