Skull Fracture: Types, Symptoms, Investigations, Treatment- Rest, Elevation, Surgery
A skull is constituted of the following bones: Parietal bone which form the sides of the skull, cranium which form the posterior side of the head, and frontal bone which is the forehead. Any sort of break or fracture to any one or all of the bones forming the skull is termed as skull fracture. The most common cause of a skull fracture is a trauma impacting the head from some sort of an object or during sporting activities. This most commonly occurs in contact sports where they can be collisions between players such as soccer, rugby etc. or being hit by a ball such as while playing cricket. A fall from a decent height on the head can also result in a skull fracture.
Skull Fractures Are Divided Into Three Types
- Linear Skull Fracture: This is one of the most common types of skull fracture and occurs in more than 50% of the cases of involving head injuries. In this type of fracture, cranial bone breaks and it looks like a very thin line. There is no bone fragmentation, distortion, or depression. The cause of it can be a small head injury such as with falling or getting hit by a stick etc. or in cases of road accidents. This fracture is in no way considered as fatal and is a simple fracture. Majority of people with this type of fracture do not experience any symptoms and there is no loss of consciousness.
- Depressed Fracture: In this type of fracture, the bone gets crushed and a part of the bone gets displaced in the direction of the brain.
- Basilar Skull Fracture: This is one of the rarest forms of skull fractures. In this, the bones located at skull base get fractured. This type of fracture is usually caused by extreme force. Basilar skull fracture can cause disruption of the bones of the middle ear. This can result in deafness or cerebrospinal fluid leak from the nose or ears. If the fractured segment of the skull comes in contact with the brain then the case becomes serious and life threatening. This often results in temporary or permanent disability and can prove to be fatal.
Symptoms of Skull Fracture
- Blood comes out from the location of the injury as well as eyes, ears or nose.
- Swelling at the location of the injury.
- Bruises eyes and ears.
- Straw colored drainage from ears or eyes.
- Changes in size of pupil.
- Severe headache.
- Incoherent speech.
- Difficulty with balance and coordination.
- Visual impairment.
- Neck stiffness.
- Photophobia and phonophobia.
- Impaired sense of smell, taste or hearing.
- Loss of consciousness.
Investigations for Skull Fracture
- Imaging studies like MRI, CT, PET, EEG etc.
- Comprehensive neuropsych evaluation.
Treatment of Skull Fracture
- Patient is advised to take ample amount of rest and to stop any sort of physical or sporting activity.
- Driving needs to be avoided.
- When the patient is resting, the head should be kept elevated above the heart level and one should be in a seated position.
- Immediate medical attention is required.
- Nothing should be given to the patient without consulting a physician.
- Patient should always have someone with them and should never be left alone.
- If the patient is vomiting, it is necessary for the head/neck to be stabilized in order to prevent choking.
- In the case of bleeding, then it needs to be stopped by using a clean cloth.
- In the case of loss of consciousness, calling an ambulance is imperative. One should never try to move the patient by themselves as there can be a spinal injury and the movement may cause the bone fragments to displace more. Also, never attempt to remove the bone fragments.
- Surgery is generally required for treatment of skull fracture.