Skull Fractures

A skull fracture is a type of head injury. It is a break in the skull bone. It may also be called a traumatic brain injury or TBI. A mild break may cause few problems and heal over time. More severe breaks can lead to bleeding in or around the brain, brain damage, leaking of cerebrospinal fluid (CSF), infection, and seizures. These need surgery right away. 

There are 4 types of skull fractures in adults that range from mild to severe:

• Linear skull fracture. This is a break in the bone, but the bone does not move out of place.

• Depressed skull fracture. Part of the skull bone is sunken in from the injury. In many cases, this needs treatment with surgery.  

• Skull base fracture. This is a break in the bone at the bottom of the skull. It can be a serious type of skull fracture. You may have bruises around your eyes and a bruise behind your ear that appear one to three days later. You may also have CSF draining from your nose or ears. This is because of a tear in part of the covering of the brain. This type of break often needs surgery right away.

Penetrating skull fracture. This is a break from something going through the bone, such as a bullet, blade, or blast fragments. This often causes severe injury and bleeding in the brain. It needs treatment right away with surgery.

The most common causes of skull fracture in adults are:

• A fall.

• Motor vehicle accident.

• Being hit with an object.

• Physical assault.

• Sports injury.

The severity of symptoms can vary. They depend on how serious the injury is. The symptoms of a skull fracture can include:

• Confusion.

• Dizziness.

• Poor memory.

• Feeling very tired.

• Headache.

• Swelling on the head.

• Bleeding from the head.

• Nausea and vomiting.

• Loss of consciousness.

• Seizures.

• Bruising behind the ears or under the eyes.

• Leaking of clear or bloody fluid from ears or nose.

The healthcare provider will ask about your health history and symptoms. Tell the healthcare provider if you are taking medicine to thin your blood, such as warfarin. He or she will ask about recent accidents or injury, and give you a physical exam. You may also have tests, such as:

• CT scan. This test uses a series of X-rays and a computer to create detailed images of the body. This test can show broken bone, blood, and injuries to the brain.

• MRI. This test uses large magnets, radio signals, and a computer to create images of tissues in the body.

• X-ray. This test uses a small amount of radiation to create images of bones and other parts of the body.

• Blood tests. These are done to check for signs of infection and other problems.

Treatment depends on how severe the injury is. A more serious injury may mean you need surgery right away. Your healthcare team will talk with you about surgery if you need it. 

Or you may be watched for a few hours in the hospital and then go home. You’ll need to rest and follow instructions about self-care. You’ll need to watch carefully for new symptoms (see below). You may also be given medicine to help prevent infection, tetanus, or seizures. Your healthcare provider will tell you more if you need medicine.

Call your healthcare provider right away if you have any of the following:

• Nausea.

• A headache that won’t go away.

• Other symptoms that don’t get better, or get worse.

Call 911 if you have any of these:

• Confusion.

• Seizure.

• Vomiting.

• Feeling very tired.

• A severe headache.

• Dizziness

• Weakness or numbness.

• Blood or fluid leaking from your nose or ear.

• Loss of consciousness.