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Patient education: Skull fractures (The Basics)

Patient education: Skull fractures (The Basics)

What are skull fractures? — A fracture is another word for a broken bone. When people have a skull fracture, they have broken 1 or more bones of their skull (head) (figure 1).

Skull fractures can happen when a person is hit hard on the head. Common causes of skull fractures are falls, car accidents, and sports injuries.

There are different kinds of fractures, depending on how the bone breaks. Some fractures are more serious than others. If the bone is only cracked, the fracture is usually not as serious. But if part of the bone is pushed in toward the brain, the fracture is more serious.

In some cases, skull fractures can lead to serious problems, including:

Brain damage

Bleeding in or on top of the brain

An infection of the tissues around the brain and spinal cord

Seizures – These are waves of abnormal electrical activity in the brain. They can make people pass out, or move or behave strangely.

What are the symptoms of a skull fracture? — Symptoms can be mild or severe, depending on where the fracture is and how serious it is. Possible symptoms can include:

Pain, swelling, or bleeding where the injury is – Sometimes, it takes a day for the swelling to start.

Headache

Feeling very tired, confused, or dizzy, or passing out

Bruising around the eyes or behind the ear

Bleeding from the nose or ear

Clear fluid draining from the nose or ear – This is spinal fluid, the fluid that surrounds the brain and spinal cord.

Vomiting

Trouble smelling, hearing, or seeing

Weakness or numbness of the face

Is there a test for a skull fracture? — Yes. The doctor will ask about your symptoms and injury, and do an exam. To look for a fracture, they can do a CT scan of the head. This is an imaging test that creates pictures of the skull and brain.

The doctor might also do an MRI or other imaging tests.

How are skull fractures treated? — Treatment depends on the type of fracture and where it is.

Many people do not need any treatment. If the skull bone only cracks but doesn't move out of place, people usually don't need treatment. But the doctor will watch them to follow their symptoms.

People whose symptoms go away after a short time can usually leave the hospital after a few hours. But the doctor will probably recommend that someone watch them at home for 24 hours to make sure that their symptoms don't get worse.

People who have a serious fracture, or symptoms that get worse, might need to stay in the hospital for a longer time. Older people, or people who take medicines that increase their risk of bleeding, usually also need to stay in the hospital. Depending on the situation, people might be treated with:

Antibiotic medicines to prevent infections

Anti-seizure medicines to prevent seizures

Treatments to lower the risk of bleeding

Vaccines – These can prevent certain serious or deadly infections.

Surgery

When should I call the doctor or nurse? — After a head injury, there are certain problems that you or your caregiver should watch for.

Someone should call for an ambulance (in the US and Canada, call 9-1-1) if you:

Are very sleepy (more than expected) or hard to wake up

Are acting confused or disoriented

Have behavior changes like angry outbursts, strange behavior, or thoughts of hurting yourself or others

Have trouble speaking, have slurred speech, or are not making sense when you talk

Have blurry eyesight, double vision, or other problems seeing

Have blood or clear liquid draining from your ears or nose

Feel dizzy or faint

Stumble or have trouble walking

Seem weak or have numbness of your arm, leg, or other body part

Have a seizure, or have jerking of your arms or legs that you cannot control

Call the doctor or nurse for advice if you:

Have trouble concentrating or thinking clearly

Have trouble remembering things

Have nausea or vomiting that is not improving

Have a stiff neck

Have a headache that gets worse, feels different, or does not get better with over-the-counter medicines

How can I help prevent skull fractures? — You should:

Wear a helmet when you ride a bike or motorcycle, or play certain sports.

Wear a seat belt every time you drive or ride in a car.

More on this topic

Patient education: Facial fractures (The Basics)
Patient education: Head injury in adults (The Basics)
Patient education: Head injury in children and teens (The Basics)
Patient education: Concussion in adults (The Basics)
Patient education: Concussion in children and teens (The Basics)
Patient education: Headaches in adults (The Basics)
Patient education: Headaches in children (The Basics)
Patient education: Moderate to severe traumatic brain injury (The Basics)
Patient education: Meningitis in children (The Basics)
Patient education: Vertigo (a type of dizziness) (The Basics)
Patient education: Seizures (The Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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