Skull Fracture: Key Information and Management

In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away.

What is a Skull Fracture?

• Break in one or more bones of the skull
• The skull is composed of many small bones protecting the brain

Types of Skull Fractures

1. Linear Fracture

• Most common type
• Appears as a thin line in the bone
• Bone does not move
• Usually requires a short hospital stay
• Surgery is generally not needed

2. Depressed Skull Fracture

• Part of the skull bones press inward on the brain
• Surgery may be necessary to lift bone pieces
• Antibiotics may be needed to prevent infection

3. Diastatic Skull Fracture

• Common in newborns and older babies
• Occurs along suture lines where skull bones meet
• Suture lines allow for brain growth

4. Basilar Fracture

• Most serious type
• Affects the base of the skull and back of the head
• Can cause bruising around eyes and ears
• Cerebrospinal fluid (CSF) may leak from nose or ears

Causes of Skull Fractures

• Vehicle accidents (car, motorcycle, bike, skateboard, ATV)
• Falls
• Blunt trauma (e.g., during fights)
• Sports injuries
• Physical abuse
• Birth injuries

Symptoms of a Skull Fracture

Mild Skull Fracture

• Small cuts, bruises, or swelling
• Pain or tenderness at injury site
• Headache
• Upset stomach
• Vomiting
• Sensitivity to noise and light
• Increased fussiness
• Memory loss of the event
• Dizziness or loss of balance

More Severe Skull Fracture

• Persistent headache
• Continuous nausea or vomiting
• Cognitive difficulties
• Slurred speech
• Walking difficulties
• Weakness on one side
• Clear fluid or blood from nose/ears
• Bruising (raccoon eyes, Battle's sign)
• Ringing in the ears
• Visual problems
• Possible loss of consciousness
• Seizures
• Difficulty waking up
• Coma

Medical Tests for Skull Fracture

• X-rays
• CT Scan
• MRI
• Blood tests
• Neurological exam (including eye exam)
• Electroencephalogram (EEG)

Treatment of Skull Fractures

Mild Skull Fracture

• Ice application
• Rest
• Oral medications for pain relief
• Ointments for cuts
• Stitches for larger cuts
• Hospital observation for 24-48 hours

More Severe Skull Fracture

• Oxygen therapy
• ICU monitoring
• IV medications and fluids
• Treatments to support vital functions, reduce brain swelling, prevent seizures, and fight infection
• Surgery
• Rehabilitation

When to Call the Doctor

• Poor eating/drinking
• Excessive vomiting
• Visual disturbances
• Behavioral changes
• Cognitive difficulties
• Severe headache
• Fluid or blood from nose/ears
• Difficulty waking
• Motor dysfunction
• Slurred speech
• Seizures

Follow-Up Treatment

• Healing time: 3 to 6 months
• Faster healing in younger children
• Avoid rough sports until cleared by a doctor
• Follow-up CT scan may be needed to monitor healing

This information is a general guide and should be discussed with your child's doctor or healthcare team for specific care instructions.