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Growing skull fracture at birth: a rare presentation of Menkes disease
  1. Helen McPherson1,
  2. Katie Prentice1,
  3. Peter W Fowlie1,
  4. Pasquale Gallo2,
  5. Philippus Brink1,
  6. Gavin Main3,
  7. David Goudie4,
  8. Alison Cozens5,
  9. Shetty Bhushan1
  1. 1Paediatrics and Neonatology, Ninewells Hospital and Medical School, Dundee, UK
  2. 2Neurosurgery, Royal Hospital for Sick Children, Edinburgh, UK
  3. 3Radiology, Ninewells Hospital and Medical School, Dundee, UK
  4. 4Genetics, Ninewells Hospital and Medical School, Dundee, UK
  5. 5Metabolic Medicine, Royal Hospital for Children, Glasgow, UK
  1. Correspondence to Dr Peter W Fowlie, Paediatrics and Neonatology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK; peter.fowlie{at}nhs.net

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A boy was born after spontaneous labour at 35 weeks’ gestation weighing 2.3 kg (25th centile). Pregnancy had been unremarkable. Labour was not augmented, and spontaneous vaginal (vertex) delivery followed with no instrumentation and no trauma. Apgar scores were 61 and 95, and no significant resuscitation was needed. Progressive occipital swelling was immediately noted. CT head demonstrated extensive comminuted and displaced skull fractures with a large subgaleal bleed (figures 1 and 2). The baby was stabilised with volume …

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