Nai: Never Actually Injured

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.