Accessory intraparietal suture

Partial or complete division of parietal bones resulting in abnormal cranial sutures is a rare entity and may result in difficulty of differentiation from fractures in small children with head trauma.

Usually, non-depressed simple skull fractures are radiolucent, with non-sclerotic borders. In contrast, accessory sutures usually present with sclerotic borders, similar to large skull capillary sutures. The presenceBilaterality of bilaterality in accessory sutures areis frequent and are symmetrical, especially in the parietal bones. However, skull fractures may also be bilateral but almost always associated with high-impact lesions and therefore often show decreased, marked depression and asymmetry, as well as intracranial lesions, as well as and soft tissue injury.

It is important to know the normal anatomy, development and chronology of sutural closure for the evaluation of the small child with head trauma withand suspected fracture.Accessory fractures and sutures can be differentiated from fractures in most cases, by observing their characteristics, such as bilaterality, symmetry, diastasis, and presence of soft tissue injury.

Identified accessoryAccessory intraparietal suture or also known as subsagittal suture, are identified in theboth parietal bone, bilaterallybones. Suspected small hairline fracture emanating posteriorly from the right intraparietal suture. The brain shows normal attenuation value, with no evidence of intracranial hemorrhage.

The reconstruction demonstrates the sutures of the skull.

The white arrows demonstrate the usually identifiable sutures and the red arrow locates the accessory intraparietal suture.