'Ping pong' fracture in a term infant.
نویسندگان
چکیده
1 of 2 DESCRIPTION We report a term infant born by emergency C-section for fetal bradycardia. Active labour was established at the time of section, resulting in the fetus being deeply impacted and diffi cult to extract. Baby was born pale and fl oppy but responded to infl ation breaths. Antenatal scans were unremarkable. She was noted to have a depression measuring 4×4 cm in the right parietal area. Skull x-ray ( fi gure 1 ) showed a depressed fracture of the right parietal bone. There was no evidence of bruising or soft tissue swelling to support an acute injury. A head CT was performed which confi rmed fracture and revealed no underlying intracerebral bleed or mass effect ( fi gure 2 ). Neurological examination was unremarkable; she was observed for 48 h and discharged home with neuro-surgical and neonatal follow-up. It is very likely that the skull depression was congenital as there was no instrumentation used in labour. Neonatal skull depressions are rare, with an incidence of 1/10 000 in western countries. 1 They can occur spontaneously (‘faulty fetal packing/congenital vault depression’) as a result of external pressure (bony prominence, uterine fi broid, fetal extremeties) or be ‘instrument – associated’ such as related to obstetric manoeuvres (forceps application). 2 3 Treatment options depend on the severity of the fracture and any underlying brain injury as identifi ed by clinical examination or with imaging. Mild forms of depression have been reported to resolve spontaneously within months. 2 However non-surgical approaches such as use of an obstetric breast milk extractor have been described. 1 Management of severe cases may require surgical elevation plus management of underlying neurological sequelae. 2 3 Images in...
منابع مشابه
“Spontaneous” ping-pong fracture in newborns: case report and review of the literature
“Ping-pong” fractures (PPF) are depressed skull fractures typical of newborns. PPF usually result from head injury and, rarely, may cause severe long-term neurological sequelae. The management of PPF is still controversial. The goal of this paper is to present a case of “spontaneous” ping-pong fracture and to review the pertinent literature of the last 20 years. We report on a newborn who prese...
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ورودعنوان ژورنال:
- BMJ case reports
دوره 2012 شماره
صفحات -
تاریخ انتشار 2012