Purpose or Case Report: To describe the imaging spectrum of injuries in children who had suffered dog bites to the craniofacial region evaluated with radiographs and/or helical Computed Tomographic (CT) scans.
Methods & Materials: This retrospective descriptive study reviewed radiographs and/or helical CT scans of patients listed as having been bitten by dogs in the craniofacial region presenting between 2000 and 2015. Depending on the extent of the bite/injury site, the evaluation included non-contrast head CT alone or with CT of the orbits, face, temporal and neck regions. Suspected penetrating vascular injury was evaluated with CT angiography.

Results: A total of 48 children presented to the emergency room with dog bite injuries between 2000 and 2015. The patients ranged from 5 months to 12 years. 36 (75%) of the patients had a CT scan and 12 (25%) had radiographs, with 9 (19%) of the patients having had both performed. The spectrum of injuries included cutaneous abrasions, lacerations of the scalp, face and neck, and orbital or periorbital injuries. In 7 (15%) of the cases, the injuries resulted in fractures. 13 (27%) of the children suffered other complications due to the attack, including intracranial extension, hemorrhage, cellulitis, intra-orbital involvement, dental injury and vascular injury.
Conclusions: In younger children, craniofacial injuries from dog bites are more common. Soft tissue lacerations were the most common injuries. Infants and young children are especially at risk for fractures and intracranial injuries from dog bites due to their small stature and thin skull. Imaging of craniofacial injuries particularly with CT scans can assess the extent of the injury and potential complications, and provide crucial information to the emergency physicians, neuro-surgeons and plastic surgeons in planning immediate treatment.