Author: Rachel Edwards / Editor: Sarah Edwards / Reviewer: Rachel Edwards / Codes: / Published: 21/06/2021 / Reviewed: 31/08/2024
A 9-year-old girl is brought to the Emergency Department (ED) by her father who is concerned about a persistent swelling on her forehead following a seemingly minor head injury.
Two weeks prior the patient had been struck on the forehead by another childs elbow in the playground. As there was no loss of consciousness, and the girl had immediately resumed normal activities, no medical attention was sought at the time. The patient developed a small egg shaped swelling at the site of injury which was noticed by her father when she returned home from school and which had slowly increased in size over the following two weeks. The patient had remained well up until 48 hours prior to presenting to ED, when she had started complaining of a left sided headache and had spiked a temperature of 38.2 on one occasion.
The patient has no past medical history of note, was born at term with no complications, is up-to-date with immunisations and has no history of recent foreign travel.
On examination, there is a 4x4cm boggy swelling in the centre of her forehead which is mildly tender on palpation and without any erythema of the skin overlying. Her observations are within normal limits, GCS 15/15, no evidence of meningism and no abnormalities detected on cranial nerve examination.
