Hemotympanum

A previously healthy 3 year-old female presented to the ED for head injury. The child was being carried by her father when he accidentally tripped and fell forward. The back of the child’s head struck the cement sidewalk—reportedly quite forcefully. However, there was no LOC, altered mental status, or vomiting. The child complained of a headache but otherwise had no other symptoms. The parents felt that “she appeared normal” to them but brought her in for evaluation because of the headache. On examination the child was smiling, interactive and had no swelling, step-offs, or other deformities to her head. She had an entirely normal neurologic examination. Wispr examination revealed this image.