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Case Reports
. 2021 May 31;14(5):e240302.
doi: 10.1136/bcr-2020-240302.

NAI: never actually injured

David Kilgarriff  1 , Sinead Brannick  2 , Edwina Daly  2 , Conor Ring  2
Affiliations
Case Reports

NAI: never actually injured

David Kilgarriff et al. BMJ Case Rep. .

Abstract

A female infant presented at 31 days of life following a head injury with concerning features for non-accidental injury. Examination revealed a noticeable depression in the left temporoparietal region with a concave depression of the left parietal bone on CT imaging. After careful consideration of the history and examination findings, along with standard investigations for non-accidental injury, the infant was diagnosed with faulty fetal packing (also known as congenital vault depression). The defect had almost completely resolved by follow-up at 5 months. This case represented a diagnostic conundrum not previously reported in the literature.

Keywords: child abuse; congenital disorders; paediatrics.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Photograph showing a notable deformity in the left temporoparietal region (image taken on day 33 of life; 11 June 2020).
Figure 2
Figure 2
CT image showing a well-defined depression in the left parietal region, without any overlying soft tissue swelling (Image taken on day 31 of life; 9 June 2020).
Figure 3
Figure 3
Three-dimensional reconstructed image showing a well-defined depression in the left parietal region (image taken on day 31 of life; 9 June 2020).
Figure 4
Figure 4
The left pinna was noted to be deformed on examination (image taken on day 5 of life; 14 May 2020).
See this image and copyright information in PMC

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