A Rare Case of a Depressed Inner Table Fracture Without an Outer Table Fracture Following Trauma in a 20-Year-Old Male Patient

Depressed skull fracture (DSF) refers to an inward distortion of the cranium, usually involving both the outer and inner tables, typically arising from blunt head trauma. These fractures can disrupt the meninges and underlying brain parenchyma. In this case report, we describe an unusual case of a 20-year-old male patient with a depressed skull fracture of the inner table with an entirely intact outer table, with no evidence of epidural, subdural, intraparenchymal hemorrhage, or contusion. The dura mater appeared intact, with no evidence of pneumocephalus or cerebrospinal fluid leakage. Three-dimensional CT reconstructions further confirmed the isolated nature of the inner table depression and the complete preservation of adjacent intracranial structures. This case report is exceptionally rare, characterized by an isolated depressed inner-table skull fracture with intact outer table, dura, and parenchyma. High-resolution CT with thin reconstructions was essential for diagnosis and guided safe conservative management.