Depressed skull fracture with traumatic epidural hematoma in a 3-day-old infant: a case report

Introduction: Traumatic brain injury represents a significant public health issue and a recurrent cause of morbidity and mortality among the paediatric population. Depressed skull fractures, where there is an inward depression of a cranial bone or section, often affect the brain parenchyma, increasing the potential risk of complications. These fractures are frequently associated with traumatic epidural hematoma, an extremely rare but significantly fatal condition in infants under one-year-old. Case Description: This case report concerns a 3-day-old male newborn brought to the healthcare unit by his parents after a fall from the bed. The infant presented as irritable and crying, with a bulge in the right parieto-occipital region and a subgaleal hematoma, with the fracture line palpable. A non-contrast head CT scan confirmed a right parietal depressed fracture and a large right parietal epidural hematoma. The fracture and hematoma were surgically repaired using a craniotomy that encompassed the fracture line, with drainage of the hematoma and anchoring of the dura mater and bone fixation with nylon thread. The postoperative period was uneventful. Conclusions: Although uncommon, skull fractures in newborns present a challenge to healthcare professionals due to the difficulty in assessing manifestations in patients who have not yet fully developed verbal communication. Enhanced diagnostic and treatment skills, coupled with timely intervention, are crucial for the effectiveness of the intervention as described in this case.