Skull fracture

Alternative names

Basilar skull fracture; Depressed skull fracture; Linear skull fracture

Definition

A skull fracture is a fracture or break in the cranial (skull) bones. See also concussion.

Considerations

Skull fractures may occur with head injuries. Although the skull is tough, resilient, and provides excellent protection for the brain, a severe impact or blow can result in fracture of the skull. It may be accompanied by injury to the brain.

The brain can be affected directly by damage to the nervous system tissue and bleeding. It can be affected indirectly by blood clots which form under the skull, but compress the underlying brain tissue (subdural or epidural hematoma).

A simple fracture is a break in the bone without damage to the skin.

A linear skull fracture is a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of bone.

A depressed skull fracture is a break in a cranial bone (or "crushed" portion of skull) with depression of the bone in toward the brain.

A compound fracture involves a break in, or loss of skin and splintering of the bone.

Causes

• Head trauma.
  
• Frequent causes of such injuries in children include: falls, automobile accidents, physical assault, and sports.
  

Symptoms

• Headache
  
• Bleeding from wound, ears, nose, or around eyes
  
• Drainage of clear or bloody fluid from ears or nose
  
• Loss of consciousness
  
• Confusion
  
• Convulsions
  
• Restlessness, irritability
  
• Drowsiness
  
• Slurred speech
  
• Difficulties with balance
  
• Visual disturbances
  
• Nausea
  
• Vomiting
  
• Swelling
  
• Bruising behind the ears or under the eyes
  
• Changes in pupils (sizes unequal, not reactive to light)
  
• Stiff neck
  

Note: The only symptom may be a bump on the head.

First Aid

1. Check the airway, breathing, and circulation. If necessary, begin rescue breathing and CPR.