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Pediatric Skull Xray

Pediatric Skull Xray. Heather Patterson August 2, 2007. Objectives. Brief review of anatomy Approach to pediatric skull xray Examples. Skull fractures. Common in non-accidental trauma 80% in first year Rare after 2y of age. Anatomy. Anatomy. Skull Xray.

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Pediatric Skull Xray

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  1. Pediatric Skull Xray Heather Patterson August 2, 2007

  2. Objectives • Brief review of anatomy • Approach to pediatric skull xray • Examples

  3. Skull fractures • Common in non-accidental trauma • 80% in first year • Rare after 2y of age

  4. Anatomy

  5. Anatomy

  6. Skull Xray • Full series 3-4 views • AP • Towne’s view (AP with neck flexed) • Lateral x 2

  7. Skull Xray

  8. Skull Xray

  9. Skull Xray

  10. Skull Xray

  11. Approach • Follow cortex • Identify suture lines • Identify abnormal lines

  12. What is the big deal? • Risk of “growing fracture” • Leptomeningeal cysts • Long term sequelae

  13. Growing fracture/Leptomeningeal Cyst • Rare • <1% of skull fractures • Pathophys • Dural deal with herniation of pia and arachnoid through tear • CSF pulsations lead to erosion of bone • Diastasis of fracture over time

  14. Growing fracture/Leptomeningeal Cyst • Imaging • Angular, linear lytic lesion • Scalloped margins • Management • f/u with neurosurgery • Early intervention as • needed

  15. Case 1

  16. Case 1

  17. Case 1 • Linear fracture R posterior parietal and occipital bones • Extends through lambdoid suture

  18. Case 2

  19. Case 2 • R parietal skull fracture

  20. Case 3

  21. Case 3

  22. Case 3 • Linear fracture R occiput

  23. Case 4

  24. Case 4

  25. Case 4 • Depressed skull fracture posterior right parietal bone

  26. Case 5

  27. Case 5 • R parietal fracture • Communicates with lamboidal suture

  28. Case 6

  29. Case 6

  30. Case 6 • R parietal fracture

  31. Case 7

  32. Case 7

  33. Case 7 • L parietal fracture

  34. Case 8

  35. Case 8 • Persistent skull defect • Encephalomalacic cystic defect • Consistent with leptomeningeal cyst

  36. Uganda

  37. Uganda

  38. Uganda

  39. Uganda

  40. Uganda

  41. Uganda

  42. Uganda

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