Findings
- Bilateral nondepressed parietal bone fractures extending to the sagittal suture bilaterally and to the squamosal suture on the left. Additional small nondepressed occipital fracture just caudal to the lambda, which extends to the left lambdoid suture
- Thin hyperattenuating collection overlying the posterior right parietal lobe and posterior interhemispheric falx, concerning for acute subdural hematoma
- Thin CSF attenuation collection overlying the right frontal convexity, which may represent a chronic subdural hematoma vs hygroma
- Partial opacification of the imaged portion of the right maxillary sinus
- Chronic-appearing left mandibular condyle and subcondylar fracture
Diagnosis
Non-accidental trauma (NAT)
Sample Report
Constellation of findings raises the question of nonaccidental trauma:
Bilateral nondepressed parietal bone fractures extending to the sagittal suture bilaterally and to the squamosal suture on the left. Additional small nondepressed occipital fracture just caudal to the lambda, which extends to the left lambdoid suture. No sutural diastasis.
Thin hyperdense collection measuring up to 2 mm overlying the posterior right parietal lobe and posterior interhemispheric falx, concerning for acute subdural hematoma. No significant mass effect, herniation, or hydrocephalus.
Thin CSF attenuation collection overlying the right frontal convexity, which may represent a chronic subdural hematoma vs hygroma.
Chronic-appearing left mandibular condyle and subcondylar fracture.
Partial opacification of the imaged portion of the right maxillary sinus.
Discussion