Case Report

Is the skull x-ray a useful tool in paediatric blunt head injury and are we familiar with an abnormal finding?

S. Andronikou, C. Welman, E. Kader, J. Venter, T. Kilborn
South African Journal of Radiology | Vol 5, No 1 | a1784 | DOI: https://doi.org/10.4102/sajr.v5i1.1784 | © 2019 S. Andronikou, C. Welman, E. Kader, J. Venter, T. Kilborn | This work is licensed under CC Attribution 4.0
Submitted: 07 August 2019 | Published: 28 February 2001

About the author(s)

S. Andronikou, Department of Paediatric Radiology, University of Cape Town; and Institute of Child Health, Red Cross War Memorial Children's Hospital, South Africa
C. Welman, Department of Paediatric Radiology, University of Cape Town; and Institute of Child Health, Red Cross War Memorial Children's Hospital, South Africa
E. Kader, Department of Paediatric Radiology, University of Cape Town; and Institute of Child Health, Red Cross War Memorial Children's Hospital, South Africa
J. Venter, Department of Paediatric Radiology, University of Cape Town; and Institute of Child Health, Red Cross War Memorial Children's Hospital, South Africa
T. Kilborn, Department of Paediatric Radiology, University of Cape Town; and Institute of Child Health, Red Cross War Memorial Children's Hospital, South Africa

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Abstract

Skull X-ray (SXR) has been, and still is, used in some institutions to detect skull fractures in paediatric head injuries. When no clinical/neurological indication for computed tomography (CT) scanning exists, the presence of a skull fracture may be used as an indication for this. This case report demonstrates an unusual SXR finding of oval lucencies in a neurologically normal child who had sustained a head injury. The subsequent CT scan demonstrated a subacute subdural haemorrhage with air pockets, highlighting the need to recognise intracranial air. The literature is reviewed regarding the usefulness of SXR in childhood head injury.

Keywords

computerised tomography; skull fracture; subdural haemorrhage; pneumocranium

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