Practice Lesson of the week

Normal skull suture variant mimicking intentional injury

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7548.1020 (Published 27 April 2006) Cite this as: BMJ 2006;332:1020
  1. P Weir, clinical fellow in neurosurgery1,
  2. N J Suttner, specialist registrar in neurosurgery1 (nsuttner@doctors.org.uk),
  3. P Flynn, consultant neuroradiologist2,
  4. D McAuley, consultant neurosurgeon1
  1. 1 Department of Neurosurgery, Royal Victoria Hospital, Belfast BT12 6BA
  2. 2 Department of Neuroradiology, Royal Victoria Hospital
  1. Correspondence to: N J Suttner
  • Accepted 14 November 2005

A presumed skull fracture might be a variant of a normal skull suture, especially when bilateral

We describe the case of a 1 year old boy with no history of trauma but a parietal soft tissue swelling. Skull radiographs showed what appeared to be bilateral skull fractures.

Case report

A previously healthy 1 year old boy was brought by his mother to the accident and emergency department after she had noticed a left parietal soft tissue swelling when he awoke. There was no history of trauma, and she had not noticed the swelling before. On examination the child was alert and the swelling was non-tender with no evidence of contusion, laceration, or abrasion.

The casualty doctor detected an abnormality on the x ray of the skull that was thought to …

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