Meningitis following basal skull fracture in two in-line skaters.

INTRODUCTION

In-line skating has been reported to cause severe head injury. Basilar skull fracture (BSF) is associated with a high risk of complication.

CASE REPORT: We report two children who had bacterial meningitis following seemingly trivial in-line skating injuries. In both, anterior BSF was diagnosed retrospectively following occurrence of Streptococcus pneumoniae meningitis.

DISCUSSION: The clinical signs indicating BSF depend on the fracture location. Plain skull radiography and computed tomography (CT) are not sensitive enough to detect thin fractures in the anterior cranial fossa. We argue that high resolution multiple-plane CT and coronal T2-weighted magnetic resonance imaging are indicated to diagnose BSF.