# Congenital depressed skull fracture in a neonate without obstetric trauma

## TL;DR

A rare case of a neonate with a congenital depressed skull fracture without any birth trauma is reported, highlighting the need for careful diagnosis and conservative treatment.

## Contribution

The paper presents a rare case of a congenital skull fracture without obstetric trauma, emphasizing intrauterine causes and conservative management.

## Key findings

- A term neonate had a 5 cm × 5 cm skull depression without intracranial injury or maternal trauma.
- Computed tomography showed a 4 mm parietal depression, likely due to intrauterine compression.
- Conservative management with follow-up was successful in a neurologically intact infant.

## Abstract

Congenital depressed skull fractures (ping-pong fractures) without obstetric trauma are rare. A term male neonate delivered via uncomplicated caesarean section, demonstrated a right parieto-temporal skull depression (5 cm × 5 cm) at birth. Computed tomography revealed a 4 mm parietal depression without intracranial injury. No instrumental delivery or maternal trauma were present. The likely aetiology was intrauterine compression (‘faulty foetal packing’). The patient was managed conservatively with close follow-up.

This case underscores the importance of perinatal history and neuroimaging in distinguishing spontaneous from traumatic fractures and supports conservative management in neurologically intact infants.