• Victoria Trenchs, Ana I Curcoy, Marta Castillo, Josep Badosa, Carles Luaces, Jordi Pou, and Ramon Navarro.
• Department of Emergency Paediatrics, Sant Joan de Déu Hospital, University of Barcelona, Spain. vtrenchs@hsjdbcn.org
• Eur J Emerg Med. 2009 Jun 1; 16 (3): 150-2.

ObjectiveTo determine the clinical evolution of children with skull fractures as a result of a minor head trauma from a witnessed accidental fall that have been studied by transfontanellar ultrasound (TFUS).MethodsObservational study for 2 years (2004-2006) of children up to 1 year of age who suffered a skull fracture after minor head trauma and for whom a TFUS was carried out as the first neuroimaging test to rule out intracranial injuries.ResultsOne hundred and twenty-three children were evaluated. The mean age was 5.7 months (SD 2.9) and the most common mechanism of injury was rolling off the bed. In seven (5.7%) patients, a computed tomography (CT) was eventually performed after TFUS; in two of these patients, this was because of the detection of possible intracranial alterations and in the others, it was because of a small fontanelle. Both patients with abnormal TFUS had a small epidural haematoma on the CT scan that did not need surgery. The clinical course for all patients was uneventful.ConclusionTFUS is a valid and reliable alternative to CT for minor head trauma in infants with skull fractures. Its innocuousness and cost-effectiveness in comparison with CT makes it a good choice in this situation.

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