Case Report

Congenital depressed skull fracture in a neonate without obstetric trauma

Elliot K. Mmutle, Baby S. Lekhuleni, Luvo Gaxa
South African Journal of Radiology | Vol 30, No 1 | a3305 | DOI: https://doi.org/10.4102/sajr.v30i1.3305 | © 2026 Elliot K. Mmutle, Baby S. Lekhuleni, Luvo Gaxa | This work is licensed under CC Attribution 4.0
Submitted: 03 September 2025 | Published: 05 February 2026

About the author(s)

Elliot K. Mmutle, Department of Radiology, Witbank Tertiary Hospital, Emalahleni, South Africa
Baby S. Lekhuleni, Department of Radiology, Witbank Tertiary Hospital, Emalahleni, South Africa
Luvo Gaxa, Department of Radiology, Witbank Tertiary Hospital, Emalahleni, South Africa

Abstract

Congenital depressed skull fractures (ping-pong fractures) without obstetric trauma are rare. A term male neonate delivered via uncomplicated caesarean section, demonstrated a right parieto-temporal skull depression (5 cm × 5 cm) at birth. Computed tomography revealed a 4 mm parietal depression without intracranial injury. No instrumental delivery or maternal trauma were present. The likely aetiology was intrauterine compression (‘faulty foetal packing’). The patient was managed conservatively with close follow-up.
Contribution: This case underscores the importance of perinatal history and neuroimaging in distinguishing spontaneous from traumatic fractures and supports conservative management in neurologically intact infants.


Keywords

congenital depressed skull fracture; neonate; non-traumatic skull depression; neonatal head injury; ping pong; CT imaging; uncomplicated delivery; paediatric imaging

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