Nondepressed linear skull fractures in children younger than 2 years: is computed tomography always necessary?

BACKGROUND

Current recommendations are that young children with a skull fracture following head injury undergo computed tomography (CT) examination of their head to exclude significant intracranial injury. Recent reports, however, have raised concern that radiation exposure from CT scanning may cause malignancies.

OBJECTIVE

To estimate the proportion of children with nondisplaced linear skull fractures who have clinically significant intracranial injury.

METHODS

Retrospective review of patients younger than 2 years who presented to an emergency department and received a diagnosis of skull fracture.

RESULTS

Ninety-two patients met the criteria for inclusion in the study; all had a head CT scan performed. None suffered a clinically significant intracranial injury.

CONCLUSION

Observation, rather than CT, may be a reasonable management option for head-injured children younger than 2 years who have a nondisplaced linear skull fracture on plain radiography but no clinical signs of intracranial injury.