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Occipital Fracture or Mendosal Suture?:Case Report | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
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Occipital Fracture or Mendosal Suture?:Case Report

Sibel Caglar Atacan*, Ajda Çetin Agırbas and Hatice Ak

The Council of Forensic Medicine, İstanbul, Turkey

*Corresponding Author:
Sibel Caglar Atacan
The Council of Forensic Medicine
İstanbul, Turkey
Tel: + 905325203489
E-mail: [email protected]

Received date: August 10, 2016; Accepted date: October 12, 2016; Published date: October 20, 2016

Citation: Atacan SC, Agırbas AC, Ak H (2016) Occipital Fracture or Mendosal Suture?:Case Report. J Clin Case Rep 6:881. doi: 10.4172/2165-7920.1000881

Copyright: © 2016 Atacan SC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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In children plane film radiographies are still most cost-effective method in evaluating skull fractures but sometimes its difficult to differentiate sutures or vascular groves from fractures. Accesory sutures, such as the mendosal suture, may be misinterpreted as a skull fracture if additional views are not obtained.


Mendosal suture; Occipital fracture; Forensic science


A 8 month old boy presented with soft tissue swelling after a fall. Plain radiographs showed sharp lucencies in the parietal and occipital bones that were told to represent fractures.CT examination with 3D reconstructions was performed and showed a vertically well defined lucency at right parietal bone and 8 mm epidural hematoma. Occipital lucency in lateral craniography that simulated skull fracture was mendosal suture (Figures 1-3).


Figure 1: A plain lateral radiograph showed a sharp lucency in right parietal bone (red arrow) representing a calvarial fracture and an occipital lucency that was mistaken for a fracture (white arrow).


Figure 2: 3D CT showed bilateral symmetric interdigitated patern of mendosal suture (arrows).


Figure 3: That is linear sharp lucency in right parietal bone accompanied by soft tissue swelling and epidural hematoma.


The mendosal suture is an accesory suture located between supraoccipital and interparietal bones.The time of closure of this suture in children changes from intrauterin period till 10 years of age [1-3]. The mendosal suture is usually bilateral,symmetrical that shows sclerotic margins and interdigitated pattern [4,5]. However skull fractures are sharp lucencies with nonsclerotic edges. Soft tissue swelling or subgaleal hematoma is frequently associated with skull fractures.


In summary differentiation between fractures and accesory sutures is made by knowledge of the normal anatomy and timing of sutural closure especially in occipital region.


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