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cross suture lines, bilateral or multiple fractures were notably more
common in nonaccidental trauma. The complete description and evaluation
of abusive or nonaccidental head trauma is discussed separately in Chapter
87 Child Abuse/Assault .

FIGURE 113.4 Depressed skull fracture. An axial CT scan with bone windows
demonstrates a closed depressed skull fracture over the left parietal bone.

Clinical Considerations
Clinical Recognition
Many of the historical and physical findings suggestive of skull fracture are
the same as described above for ciTBI. The history may include a witnessed