Ultrasound Detection of Skull Fractures in Infants After Head Trauma

Management of pediatric head trauma demands a careful balance between achieving accurate diagnoses and ensuring patient safety, particularly in minimizing radiation exposure. Ultrasonography (US) has emerged as a promising tool in this context. A noteworthy case study involved a 10-month-old infant who presented with acute swelling in the right parietal region. In this instance, US effectively identified a hypoechoic lesion corresponding to the swelling, as well as a suspected fracture line in the cranial vault and the presence of a subdural hematoma. The subsequent computed tomography (CT) scan confirmed the cranial fracture, while magnetic resonance imaging (MRI) later validated the existence of the subdural hematoma. At a one-month follow-up, MRI indicated that the hematoma was reabsorbing, and US demonstrated the formation of a bone callus in its advanced healing phase. While ultrasonography is not yet considered a standard practice for evaluating pediatric head trauma, its ability to detect cranial fractures in infants highlights its potential utility. Specifically, when US reveals a fracture, it may serve as a valuable indicator for the necessity of further neuroimaging. This approach could lead to a significant reduction in ionizing radiation exposure for pediatric patients, aligning with contemporary trends in pediatric care that prioritize patient safety and minimize unnecessary diagnostic procedures. As research into the efficacy and application of US in this setting continues to develop, its integration into clinical practice may pave the way for improved outcomes in the management of pediatric head trauma.