Bilateral Parietal Skull Fractures in Infants Attributable to Accidental Falls

<b><i>Introduction:</i></b> Multiple skull fractures, including bilateral parietal skull fractures (BPSFs) in infants are considered to be suspicious for abusive head trauma (AHT). The aim of this report is to describe a series of BPSF cases in infants which occurred due to accidental falls. <b><i>Methods:</i></b> We searched our neuroradiology database for BPSF in infants (&#x3c;1 year old) diagnosed between 2006 and 2019; we reviewed initial presentation, mechanisms of injury, clinical course, head imaging, skeletal survey X-rays, ophthalmology, social work and child abuse physicians (CAP) assessments, and long-term follow-up. “Confirmed accidental BPSF” were strictly defined as having negative skeletal survey and ophthalmology evaluation and a CAP conclusion of accidental injury. <b><i>Results:</i></b> Twelve cases of BPSF were found; 3 were confirmed to be accidental, with a mean age at presentation of 3 months. Two infants had single-impact falls, and 1 had a compression injury; all 3 had small intracranial hemorrhages. None had bruises or other injuries, and all remained clinically well. A literature search found 10 similar cases and further biomechanical evidence that these fractures can occur from accidental falls. <b><i>Conclusion:</i></b> While AHT should be kept in the differential diagnosis whenever BPSFs are seen, these injuries can occur as a result of accidental falls.