Abstract
Depressed skull fracture in neonates is usually associated with trauma at delivery. So-called “spontaneous” congenital or intrauterine depressed skull fracture in newborn babies rarely occurs and has been infrequently documented in the literature. A case of congenital depressed skull fracture in a newborn infant, possibly resulting from cephalo-pelvic disproportion at delivery is presented.
A 3, 240g female infant was delivered vaginally by vertex presentation of a gravida i, para i, 39-year-old woman at 40 weeks of gestation. Delivery was prolonged and an obstetrical vacuum extractor was used. Apgar score was 8 at 1 minute. At birth a right frontal skull depression, measuring 4×4 cm, was noted. The infant was admitted when she was 50 days old. On admission physical and neurological findings were unremarkable except for the right frontal skull depression. Plain skull films and computed tomography scans demonstrated a ping-pong ball fracture of the right frontal bone without any fracture line. Cranioplasty was performed uneventfully when the infant was 52 days old. A flat sacrum and contracted pelvis were observed on the mother's pelviogram.
Congenital or intrauterine depressed skull fracture of the newborn is reviewed and the pathogenesis of this condition is discussed.
