Bony injuries of skull (Skull fractures)

A skull fracture is a break in the cranial bone also known as skull. The skull can break or fracture if it is subject to direct or forceful impact. People with skull fracture need to be treated as soon as possible. 

The extent of injury in skull fractures depends on:

  • How deep the fracture is
  • Has the fracture also affected the skin, blood vessels, sinuses and mucous membrane. 
  • The affected bone or bones

Causes of Skull Fracture

Any type of impact to the head can cause a skull fracture. It mainly results from head trauma.

Injuries that cause skull fractures include

  • Fall from height 
  • Sport Injuries
  • Car Accidents
  • Physical assault

Types of Skull Fractures

Skull Fractures have been classified as per how severe the injury is 

  • Simple Fracture

Skull is fractured without damaging the skin

  • Linear Fracture

When the fracture is one thin line with no additional lines splintering from it and there is no distortion of bones. 

  • Compound Fracture 

Where there is splintering of skull bone no the brain as well injury to the scalp along with multiple location of head injury 

  • Depressed Fracture

fracture causes displacement of bone towards the brain

Symptoms of Skull Factories

Less severe symptoms:

  • Headache
  • Nausea
  • Vomiting
  • Blurred Vision
  • Restlessness
  • Irritability
  • Loss of Balance
  • Stiff Neck
  • Confusion
  • Excessive Drowsiness
  • Fainting
  • Coma 

Serious Symptoms:

  • Severe pain at trauma site.
  • Swelling at the trauma site.
  • Bleeding from the wound caused by the trauma or around the eyes, ears or nose.
  • Bruising around the trauma site or under the eyes ( raccoon eyes) 
  • Redness or warmth at the trauma site.

Treatment for Skull Fractures

Initially this patients present in emergency with above mentioned symptoms. The initial assessment by emergency doctors as well as surgeons decide the further course of management. 

In routine practice, thorough evaluation of the patient is must to rule out other injuries. Non- contrast computerised tomography ( Ct scan) of the year is done to rule out internal injury. Depending upon the patients condition he is admitted in critical care unit or obervation for treatment. 

Skull fractures aren’t treated like other bone fractures. Treatment will depend on various factors like your age, health, medical history, type of fracture, severity of the symptoms and patients general condition. 

Minor skull fractures aren’t too painful and the skull will heal itself. Few other skull fractures may be just treated with pain medication.

Indications of surgery in head injury with skull fracture 

  1. Depressed skull fractures
  2. Fragments of bone impending the brain matter 
  3. Associated intracranial haemorrhage causing mass effect on the brain
  4. Cerebrospinal fluid leak from  ears or nose 
  5. Actively bleeding from fracture or intracranial bleeding 

Patients may require emergency surgery in such cases to improve the outcomes of the patient. Usually recovery depends upon the degree of injury. In case multiple brain contusions , brain herniation and massive subarachnoid bleeding the prognosis is poor  

Preventive measures to avoid head injury 

While all head injuries are not avoidable people can take measures to reduce the risk of head trauma. This include

  • Wearing a helmet while riding a bicycle or scooter.
  • Avoid drink and drive. 
  • Wearing  a seat belt while driving.
  • Wearing safety gears while playing sport.

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