Traumatic Tension Pneumocephalus(TTP) is very rare in children. It occurs most often as a result of temporal or basal skull fracture, and may cause neurological deterioration. CT scan findings are considered pathognomonic. A 16-month-old girl presented with unstable vital signs and a single seizure episode after being struck by a reversing car. A day later she developed rhinorrhea and a high grade fever. CT of the brain demonstrated a Mount Fuji sign. Her neurological status remained essentially normal. She was managed non-operatively and was discharged uneventfully eight days after the accident. In selected paediatric cases, TTP may be managed non-operatively.

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