2/18/2024 0 Comments Basilar skull fracture xray![]() 8 The 3D data set can be made available by simple postprocessing techniques immediately after the 2D image acquisition and is a potential valuable source of information with no added cost, scan time, or radiation exposure. 11 The high sensitivity of high-resolution volume-rendered (VR) 3D CT in detecting skull fractures was reported in 6 pediatric human cadaver skulls after they were exposed to head drop tests. Multidetector CT (MDCT) provides an isotropic volume data set from which 2D, multiplanar, and 3D reconstructions can be obtained. The presence of scalp swelling or hematoma and intracranial injury such as contusion or hemorrhage may also be helpful in identifying a subtle fracture. Routine imaging evaluation in pediatric head trauma includes assessment of the following: 1) CT scout image, 2) axial 2D images in bone and soft-tissue windows, and 3) 2D multiplanar reformatted images in both coronal and sagittal planes. 6 A skull fracture may be an indicator of intracranial injury hence, an accurate diagnosis in pediatric head trauma is important. Intracranial injury is a leading cause of mortality and morbidity in children. 10 Secondary injury is a complication of the primary injury (e.g., stroke due to hematoma-related herniation) and may occur with a delay in time after the initial trauma. 10 Primary injury as a consequence of direct impact includes, for example, epidural and subdural hemorrhage, diffuse axonal injury, and cortical contusion. 15 Intracranial injury may be primary or secondary. Conversely, 40%–100% of intracranial injuries have an associated skull fracture. 10, 15 Linear skull fractures are associated with intracranial injury in 15%-30% of patients. 10, 15 The parietal bone is most commonly fractured (approximately 60%–70% of the time). Linear fractures account for approximately 75% of all fractures. Skull fractures may be linear, depressed, diastatic, or basilar (skull base). 15 Routine 2D CT images may not be sufficient to identify subtle fractures or linear fractures orienting in the axial plane on images or reconstructions. 5 Head CT identifies posttraumatic skull fractures with high sensitivity. S kull fractures occur in up to 2% of all children 2 and 11% of children under 2 years of age following head trauma.
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