Anomalous Parietal Suture Mimicking Skull Fracture

Tharp, Amy M.; Jason, Donald R.

doi:10.1097/paf.0b013e3181859fd0

Cited by 15 publications

(6 citation statements)

References 6 publications

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“…An important point for the neurosurgeon, radiologist, pediatrician, forensic pathologists is the skull fracture lines. Differential diagnosis of the fracture lines, crack and fissure intrasutural bone presentations that might be rendered in the bone tissues in the radiograms must be accomplished (4,25). The features of these bones, their appearance and position give us a more definitive diagnosis.…”

Section: Govsa F Et Al: Wormian Bone For Importance Of Cranial Fracturementioning

confidence: 99%

“…In forensic medicine it has also importance (1,3,4,25). The variation might be person spesific so that it might be a fingerprint.…”

Section: Significance Of the Presence Of Intrasutural Bonesmentioning

confidence: 99%

“…Sometimes this awareness will save someone not to be called guilty. The variants of occipital bone, interparietal bones, preinterparietal bones or sutural bones might be mixed with fissured fractures (1,3,4,25).…”

Section: Significance Of the Presence Of Intrasutural Bonesmentioning

confidence: 99%

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Anatomoradiological identification of intrasutural bones for importance of cranial fracture

Gövsa¹,

Özer²,

Bayraktaroğlu³

et al. 2013

Turkish Neurosurgery

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AIm: Intrasutural bones are often found within sutures and fontanelles of the skull. It is important that the anatomy of these bones in the field of non-accidental injury with respect to medicolegal complications. Skull fracture lines are critical in their differential diagnosis, and the features of bone formations, their appearance and position give us a more definitive diagnosis. mATERIAL and mETHods: Intrasutural bone location, its number and symmetry were investigated in totally 300 adult skulls.REsuLTs: 27 intrasutural bones were identified as interparietal (2%), preinterparietal (3%) and sutural bones (4%) were in the lambdoid sutures. It was detected that the interparietal and preparietal bones were single, and the sutural ones were in a multiple number. The sutural bones were superposed in significant structures such as sagittal sinus and sinus sigmoideus. CoNCLusIoN:The ones that should be paid attention to in the differential diagnosis of the skull fracture lines are preinterparietal and interparietal bones in larger sizes. These findings prompted us to report these cases as their presence can lead to confusion in diagnosis in cases of skull fractures. BuLGuLAR: 27 tane sütüral kemik tanımlandı: interparietal (%2), preinterparietal (%3) ve sütüral kemik (%4) tanımıyla lambdoid sütür kemiği. Interparietal ve preparietal kemikler tek, sütüral olanları ise çok sayıda idi. Sütüral kemikler aynı zamanda sagittal sinüs ve sigmoid sinüs gibi önemli yapıların üzerine yerleşmiş idi. soNuÇ: Preparietal ve interparietal kemiklerin daha büyük boyutlarda olması kırık hattı ayırıcı tanısında dikkat edilmelidir. Bu olgularda elde ettiğimiz kemiklerin, tanıda kafa kırıkları ile karışabileceği yönündedir.

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Section: Govsa F Et Al: Wormian Bone For Importance Of Cranial Fracturementioning

confidence: 99%

“…In forensic medicine it has also importance (1,3,4,25). The variation might be person spesific so that it might be a fingerprint.…”

Section: Significance Of the Presence Of Intrasutural Bonesmentioning

confidence: 99%

See 1 more Smart Citation

Anatomoradiological identification of intrasutural bones for importance of cranial fracture

Gövsa¹,

Özer²,

Bayraktaroğlu³

et al. 2013

Turkish Neurosurgery

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“…Other autopsy findings are more challenging in terms of their significance as markers of child abuse with potential inaccurate interpretation if one is unaware of their true etiology. For instance, a recent case report describes anomalous suture defects of the parietal skull that simulate a traumatic fracture on gross examination, unless one is aware of this entity and performs microscopic examination (8). …”

Section: Commentmentioning

confidence: 99%

Disseminated Neonatal Herpetic Infection Simulating Abusive Anal Trauma

Panella

2011

Journal of Forensic Sciences

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Potential simulators of premortem trauma present problems of misinterpretation and possible false accusations of caregivers. A case of unsuspected neonatal herpes is reported with associated perianal ecchymosis that raises the possibility of sexual abuse. The decedent was an 8-day-old newborn infant who was born by Cesarean section and treated for 5 days postdelivery for sepsis. The newborn infant was discharged home but returned 2 days later with probable sepsis and new onset of perianal hemorrhage. She died 1 day later with autopsy, revealing neonatal disseminated herpetic infection with early anal involvement consisting of microscopic ulcerations with leukocytoclastic-like vasculitis and rare viral cytopathic changes. These histological changes produced grossly appearing anal ecchymosis with an absence of typical herpetic vesiculopapular lesions, which simulated abusive trauma. This case highlights the importance of considering occult neonatal herpes with associated perianal ecchymosis when presented with possible abusive anal trauma in a newborn infant.

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“…Distinguishing accessory sutures from true fracture may remain difficult, and may lead to false allegations of abuse. 23,24,25,26 In one case report of a 1-year-old male brought in for parietal soft tissue swelling without any witnessed history of trauma, bilateral symmetrical markings on plain radiographs were thought initially to be fractures. A thorough investigation for non-accidental injury revealed no additional findings, and review of the radiographs led to an accurate diagnosis of congenital subsagittal sutures with a presumed minor unwitnessed fall causing transient scalp swelling.…”

Section: Introductionmentioning

confidence: 99%

The infant with bilateral skull fractures: diagnostic considerations in consultation with a child abuse pediatrician

O'Hara

2019

J Inj Violence Res

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:Bilateral skull fractures in infancy may result from accidental or abusive injury. Consultation with a child abuse pediatrician may assist with determining the likelihood of accident or abuse. Diagnostic considerations for the infant with bilateral skull fractures are reviewed, including single impact, double impact, and compression mechanisms of injury, as well as the possibility of accessory sutures as skull fracture mimics. Illustrative cases exemplify the evaluative process, including obtaining a detailed history, assessing for the presence or absence of additional physical or radiographic signs of injury, screening for psychosoical risk, and obtaining three-dimensional reconstruction of CT bone images. An understanding of plausible mechanisms of injury that can result in bilateral skull fractures in infancy can assist with making an accurate determination of likelihood of accident or abuse.

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Anomalous Parietal Suture Mimicking Skull Fracture

Cited by 15 publications

References 6 publications

Anatomoradiological identification of intrasutural bones for importance of cranial fracture

Anatomoradiological identification of intrasutural bones for importance of cranial fracture

Disseminated Neonatal Herpetic Infection Simulating Abusive Anal Trauma

The infant with bilateral skull fractures: diagnostic considerations in consultation with a child abuse pediatrician

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