Skull Fracture

Skull fracture head injury

Last Updated January 4th, 2022

The most common symptoms of skull fracture include headache, bruise at the fracture site, bleeding from the wound, drowsiness, slurring of speech, and bleeding from the nose, ears, or mouth.
Majority of skull fractures generally heal on their own over a period of time. Pain may persist for few days and gradually dissipate. The complete healing process may last several months. A more severe skull fracture needs surgical intervention.
Skull fractures are broadly divided into four types namely linear skull fracture, depressed skull fracture, diastatic skull fracture, and basilar skull fracture. Linear skull fracture is the most commonly occurring skull fractures and generally requires minimal to no intervention.
CT scan of the head is the most common imaging test that is used to diagnose skull fractures. CT scan of the head can determine if there is any bleeding, inflammation, brain injury, and fracture in the skull. On the other hand, head x-ray can determine only the fracture in the head.

What is a skull fracture?

A skull fracture is defined as a break or discontinuity in any of the eight cranial bones. It mainly occurs due to sustained injury or blunt force trauma. The bones in the vicinity of the site of impact may also suffer a fracture if the intensity of the trauma is excessive. This may cause the underlying structures such as the blood vessels, the membrane and most important, the brain to get injured badly. An uncomplicated skull fracture may not give rise to severe damages, but it may lead to associated physical or neurological damage in future. If the impact of the blow is significant, it may lead to a concussion, possibly with the loss of consciousness.

 

Which parts of the skull are impacted?

Skull fracture xrayThe following cranial structures are impacted by a skull fracture-

  • Frontal bone (thin squamous layer)
  • Parietal bone (thin squamous layer)
  • Temporal bone
  • Occipital bone
  • Sphenoid sinus and wings
  • Ethmoid bone
  • Lamina externa
  • Foramen magnum
  • Petrous temporal ridge
  • Diploe
  • Glabella
  • External occipital protuberance
  • Middle cranial fossa
  • Anterior cranial fossa (roof of the orbits)
  • Posterior cranial fossa (the area between mastoid and dural sinuses)
  • Mastoid processes
  • Cribriform plate

 

What are the main causes of skull fracture?

The common causes of skull fracture are as follows-

 

Different types of skull fractures

  • Linear skull fracture: Linear skull fractures are the breaks or discontinuities in the bone that extend from the outer to the inner table of the skull and cover almost the entire thickness of the skull. These fractures are almost straight and hence the name linear. Bone displacements do not take place in this case. The linear fractures usually arise from blunt force trauma, wherein the impact energy is transmitted over a wide area of the skull.

Linear skull fractures are usually uncomplicated. In those cases where the venous sinus groove or the vascular channel is involved, the linear fractures are serious and need medical intervention. These conditions may lead to certain associated complications like diastasis, epidural hematoma, and venous sinus thrombosis. In very small children, the skull fracture may grow, especially if it takes place in the parietal bone.

  • Depressed skull fracture: This type of fracture also results from blunt force trauma, such as getting struck in the head by an object. These are basically comminuted fractures wherein the broken bone fragments are moved inwards. These types of fractures increase the risks of pressure on the brain or brain hemorrhage. Both these conditions can lead to severe damage to the delicate tissue.

Different types of depressed skull fractures

Skull fracture head injuryMinor depressed skull fractures are uncomplicated. But there is another type of skull fracture which has serious consequences. It is known as compound depressed skull fracture. In this case, there is a laceration over the fracture, that exposes the internal cranial cavity to the outer environment. This consequently increases the possibilities of infection and contamination.The depressed fractures where the dura mater is torn are known as the complex depressed fractures. Surgical interventions are necessary in these cases to lift the bone fragments off the brain.

  • Diastatic skull fractures: In these cases, widening of the sutures of the skull occurs after one or more sutures of the skull get impacted by the progressing fracture line. In adults, a diastatic fracture severely affects the lambdoidal suture. This happens because this suture does not completely close or fuse in the adults before the age of 60.
  • Basilar skull fracture: These are found on the floor of the cranial vault, that is, the skull base. This is caused by a greater force than the remaining parts of the neurocranium. The characteristic features of basilar skull fracture are – blood in the sinuses, leakage of cerebrospinal fluid (CSF) from the nose (rhinorrhea) or from the ears (otorrhea), periorbital ecchymosis (bruising of the orbits of the eye)
  • Growing skull fracture: It is also known as a Leptomeningeal cyst or Craniocerebral erosion. It is typically observed in older children in the atypical regions of the skull such as the basioccipital region and is often associated with other types of skull fractures. It is called growing fracture because a diastatic enlargement of the fracture can be seen.
  • Cranial burst skull fracture: It is a closed diastatic skull fracture normally observed in children less than a year old. It is characterized by a diastatic skull fracture with cerebral extrusion beyond the external table of the skull under the scalp.

Compound elevated skull fracture

It is a rare category of skull fracture where the fractured or injured bone is raised above the intact outer table of the skull. The underlying meninges is badly affected in this case.

 

Diagnosis

The following diagnostic tests can detect the occurrence of skull fracture-

  • MRI scan
  • CT scan
  • Radiography

 

Treatment & Prevention

Skull fracture treatmentThe treatment of skull fractures is quite different from that of other types of fractures. The exact treatment method depends upon a variety of factors such as the extent of the injury, type of skull fracture, age and overall health of the patient. In many cases, the skull heals by itself. The patient is given pain-killer medicines such as Tylenol. If there is an excess leakage of the cerebrospinal fluid from the brain (nasal fracture), a surgery might be required. If the skull fracture is of the depressed category (broken pieces of skull pushed inwards), then surgery is a mandate. It takes a minimum of 6 weeks for the skull to heal on its own.

Skull injuries and fracture can be largely prevented by wearing protective headgear while riding a bike or playing high impact sports. If working in a place, where the safety of your skull could be compromised (construction site), then it is important to wear a helmet all the time.

 
 

Facts

  • Bleeding from ears is a sign of a fractured skull. This is because blood might have collected behind the ear drum due to the trauma or injury.
  • In many cases, there might be a discharge of a clear fluid from the ears or nose. This is nothing but the cerebrospinal fluid.

Facts

  • X-rays are hardly of any help in case of skull injuries. CT scan and MRI are helpful in detecting the extent of the injury.
  • Loss of balance, troubled speech and lack of coordination indicate brain damage due to the skull fracture.

Facts

  • When the pieces of skull push inwards, they create what is known as depressed fractures. It can lead to infection and collection of pus in the brain.

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The most common symptoms of skull fracture include headache, bruise at the fracture site, bleeding from the wound, drowsiness, slurring of speech, and bleeding from the nose, ears, or mouth.
Majority of skull fractures generally heal on their own over a period of time. Pain may persist for few days and gradually dissipate. The complete healing process may last several months. A more severe skull fracture needs surgical intervention.
Skull fractures are broadly divided into four types namely linear skull fracture, depressed skull fracture, diastatic skull fracture, and basilar skull fracture. Linear skull fracture is the most commonly occurring skull fractures and generally requires minimal to no intervention.
CT scan of the head is the most common imaging test that is used to diagnose skull fractures. CT scan of the head can determine if there is any bleeding, inflammation, brain injury, and fracture in the skull. On the other hand, head x-ray can determine only the fracture in the head.

 

Dos and Don'ts

Dos
  • Seek immediate medical help if there is bleeding from ears and/or nose after a trauma or injury to head.
  • Rush to the hospital if the injured person experiences nausea after a head injury and shows signs of slurred speech and blurred vision.
Don'ts
  • Move the injured individual. Wait for medical help to arrive.
  • Remove any protruding objects from the site of the injury.
  • Administer any drug or medication without the consultation of the doctor.

 

 

 

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What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Atkins diet weight loss
Atkins Diet: The right steps to carb control that can help you lose those pounds fast The Atkins diet is a high fat, low-carb diet with proven weight loss benefits that is flexible enough…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…