Skull Fracture

Definition

is a break in one or more of the eight bones that form the cranial portion of skull fracture .blunt force trauma,.

Types of skull fracture :

Linear skull fracture:A fracture that extends through the entire thickness of the skull

Depressed skull fracture:-Bone fragments are pushed blow the surface of the skull, against the brain.-Caused by a high impact injury to a small area of the skull by a blunt object

Basilar skull fracture:A fracture at the base of the skull

Temporal skull fracture:A fracture in the temple

Symptoms :

There are a large number of tell-tale signs when pin pointing a skull fracture, these include:HeadacheConfusion, drowsiness (also typical signs of a concussion)Temporary or long-term loss of consciousnessVomiting, sicknessSwelling and pain in the affected areaBlurred visionSwelling and bruising around the eyes and noseParalysis or weakness of the facial area

How to Diagnose a Skull Fracture Obtain a patient history. Most linear skull fractures do not produce systemic symptoms. Some swelling at the site of impact may be present and the skin may be breached.

Examine the patient for more serious symptoms of a skull fracture. These include bleeding from the wound, ears or nose, headaches and tenderness at the site of impact.

Look for signs of neurological deficit, including blurred vision, confusion, loss of balance or consciousness, convulsions, drowsiness, irritability, nausea, changes in pupil size, slurred speech, stiffness in the neck and vomiting.

Perform Computed Tomography (CT) scans as an essential imaging technique for detecting skull fractures. 

Use CT images with wide windows to prevent linear or slightly depressed fractures from being overlooked.

Treatment of skull fractures:

Linear Skull Fracture:Most linear skull fractures do not require specific treatment. A simple, relatively straight-line crack is detectable in X-rays or CT scans and will eventually heal on its own.

Basilar skull fractures with evidence of cranial nerve injury or persistent CSF leakage:Operative repair may be required if there is evidence of cranial nerve injury (e.g., hearing loss persisting for >3 months, facial paralysis) or persistent CSF leakage.CSF leakage may initially be treated with lumbar drainage; if the CSF leakage is persistent, primary surgical treatment is endoscopic intranasal surgical repair, which has a better outcome and lower morbidity than craniotomy. The most common complication of intranasal surgery is anosmia.

Comminuted Skull Fracture:The treatment depend on the severity :A simple comminuted fracture – with the bones remaining in alignment and not depressed – is itself not exceptionally serious. Similar to a linear fracture, the bone can be expected to heal without specific treatment.If bone fragments are dislodged, surgery may be required to align or remove fragments. If the bone has not penetrated the dura and there are no signs of injury beyond a possible concussion, a full recovery can be expected.

Depressed skull fracture :Treatment is often determined by the depth of the depression, whether it’s accompanied by an open wound, and the degree of accompanying brain trauma: In the best case, the depression is not greater thanـــ the skull’s thickness and the skull is not exposed in this case the fracture may not be treated and allowed to heal on its own. Deeper depressions and those with open wounds ـــare frequently accompanied by damage to the brain. Surgery to elevate the bone and remove any fragments is often required. Surgery may also be needed to treat bleeding inside the skull.

The majority of skull fractures require no specific treatment because the break in the bone heals naturally with time. Treatment objectives are primarily for controlling pain, promoting healing, and preventing complications. The primary concern with a skull fracture is potential traumatic brain injury, for which treatment varies significantly based on the type of injury.

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