Definition

What is a skull fracture?

A skull fracture is any break in the cranial bone, also known as the skull. There are many types of skull fractures, but only one major cause: an impact or a blow to the head that’s strong enough to break the bone. An injury to the brain can also accompany the fracture, but that’s not always the case.

The type of skull fracture depends on the force of the blow, the location of the impact on the skull, and the shape of the object making impact with the head.

A pointier object is more likely to penetrate the skull than a hard, blunt surface, such as the ground. Different types of fractures lead to differing levels of injury and trauma.

  • Closed fracture. With a closed fracture, also called a simple fracture, the skin that covers the fracture area isn’t broken or cut.
  • Open fracture. Also known as a compound fracture, an open fracture occurs when the skin is broken and the bone emerges.
  • Depressed fracture. This refers to a fracture that causes the skull to indent or extend into the brain cavity.
  • Basal fracture. A basal fracture occurs in the floor of the skull: the areas around the eyes, ears, nose, or at the top of the neck, near the spine.
  • Other types. In addition to the above types, fractures can also classify as:
    • Linear (in a straight line)
    • Comminuted (broken into three or more sections)

How common are skull fractures?

Skull fractures are quite common. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of skull fractures?

The common symptoms of skull fractures are:

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

In some cases, the only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • There are problems with breathing or circulation.
  • Direct pressure does not stop bleeding from the nose, ears, or wound.
  • There is drainage of clear fluid from the nose or ears.
  • There is facial swelling, bleeding, or bruising.
  • There is an object protruding from the skull.
  • The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly.

Causes

What causes skull fractures?

A skull fracture occurs when a force that’s strong enough to break the bone hits the skull. Any type of impact to the head can cause a skull fracture. This includes being hit with an object, falling and hitting the ground, injuring the head in a car accident, or any other type of trauma.

Risk factors

What increases my risk for skull fractures?

There are many risk factors for skull fractures, such as:

  • Male sex
  • Fall from height
  • Motor vehicle accident (MVA)
  • Assault resulting in head trauma
  • Gunshots to the head

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How are skull fractures diagnosed?

A doctor may be able to diagnose a fracture by simply performing a physical examination of the head. However, it’s useful to diagnose the extent and exact nature of the damage. This requires more specific diagnostic tools.

Doctors can use various imaging tests to get a clearer picture of the kind of fracture you have and how far it extends. X-rays, CTs, and MRIs are typical methods for imaging the body and can help your doctor diagnose skull fractures.

An X-ray provides an image of the bone. An MRI takes an image of the bone and soft tissue. This allows your doctor to see both the skull fracture and the brain.

The most common tool used is a CT or CAT scan. This test usually provides the clearest picture of the fracture and any damage to the brain because it produces a 3-D image.

How are skull fractures treated?

Skull fractures aren’t managed exactly like other bone fractures. Treatment will depend on several factors. Your doctor will take into consideration your age, health, and medical history, as well as the type of fracture, its severity, and any resulting brain injuries.

Most skull fractures aren’t too painful, and the skull will heal itself in a majority of these instances. In some cases, such as in basal skull fractures, medication to manage pain may be all that’s needed. Although narcotics may sometimes be necessary, most people with a skull fracture only need over-the-counter medications such as acetaminophen (Tylenol) for a short course.

However, a basal fracture may require surgery if it results in excessive leakage of cerebrospinal fluid (the liquid that cushions and surrounds the brain and spinal cord) from the nose and ears.

Surgery is more often a required course of treatment for depressed skull fractures if the depression is severe enough. This is because depressed skull fractures have a harder time healing on their own.

Depressed skull fractures could result in not only cosmetic issues, but also potential for further injury to the brain if the fracture isn’t corrected. Surgery may also be necessary if the depression puts pressure on the brain or if there’s cerebrospinal fluid leakage.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage skull fractures?

The following lifestyles and home remedies might help you cope with skull fractures:

  • You may need to rest in bed with your head raised for a period of time after your injury. Avoid straining, such as blowing your nose, sneezing, and lifting heavy objects. Straining may increase the pressure in your head. If fluid from around your brain is leaking, straining may worsen the leak.
  • A neck brace may be needed to prevent you from moving your head and neck. A neck brace may be soft or hard and helps prevent further injury while your fracture heals. A neck brace may also help decrease neck pain. Ask for more information about a neck brace and about how to care for it.
  • Vestibular rehabilitation may be needed if you have problems with dizziness. You will learn activities that will help improve your balance and decrease your dizziness.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 26, 2018 | Last Modified: August 26, 2018

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