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Skull fracture

Contents of this page:


Skull of an adult
Skull of an adult
Skull fracture
Skull fracture
Skull fracture
Skull fracture
Battle's sign - behind the ear
Battle's sign - behind the ear
Infant skull fracture
Infant skull fracture

Alternative Names    Return to top

Basilar skull fracture; Depressed skull fracture; Linear skull fracture

Definition    Return to top

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

Considerations    Return to top

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. The brain can also be affected indirectly by blood clots that form under the skull and then 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    Return to top

Symptoms    Return to top

Note: The only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop.

First Aid    Return to top

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

2. Avoid moving the victim (unless absolutely necessary) until medical help arrives. Instruct someone to call 911 (or the local emergency number) for medical assistance.

3. If the victim must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn.

4. Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be difficult to know if the skull is fractured or depressed (dented in) at the site of injury.

5. If there is bleeding, apply firm pressure with a clean cloth to control blood loss over a broad area.

6. If blood soaks through, do not remove the original cloth. Instead, apply additional cloths on top, and continue to apply pressure.

7. If the victim is vomiting, stabilize the head and neck (as outlined in number 3, above), and carefully turn the victim to the side to prevent choking on vomit.

8. If the victim is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the patient does not think medical assistance is necessary).

DO NOT    Return to top

When to Contact a Medical Professional    Return to top

Prevention    Return to top

1. Use car seats or seat belts whenever in a motor vehicle.

2. Use helmets whenever biking, skating, skiing, climbing, or playing contact sports.

3. Use equipment designed specifically for the type of sport or recreation in which you are participating.

4. Provide appropriate supervision for children of any age.

5. Do not allow children to bike or skate at night.

6. Provide highly visible clothing.

7. Teach children to obey traffic rules and signals.

8. Educate individuals about risks of various work, recreational, or sport activities and how to avoid injury.

9. Report any concerns you might have about abuse.

References    Return to top

Dias MS. Traumatic brain and spinal cord injury. Pediatr Clin North Am. 2004;51(2):271-303.

Marx J, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006.

Update Date: 2/19/2008

Updated by: John E. Duldner, Jr., MD, MS, Assistant Professor of Emergency Medicine, Director of Research, Department of Emergency Medicine, Akron General Medical Center and Northeastern Ohio Universities College of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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