A skull fracture is a fracture of the bone in the area of the skull. Thus, skull fracture is one of the head injuries that occur in the majority of cases due to the external impact of force on the skull. In addition, the brain can also be damaged by the skull fracture.
What is a skull fracture?
In a skull fracture, a fracture, or by medical term, a fracture, has formed in the bone of the skull. In most cases, this is the result of violent force applied to the skull bone. A skull fracture often occurs in conjunction with other types of head injuries, because when the fracture occurs in the skull bone, the surrounding areas are usually also injured in various ways. Basically, skull fracture is distinguished in diverse forms and manifestations or degrees of severity. If the violent force has only injured the bone of the skull, this is called either a skull contusion or a skull fracture. While in a skull contusion the force was not strong enough to cause a fracture of the skull bone, in a skull fracture there is a clear break in the skull. If the force was so severe that the brain is also affected by the injuries, this is known as a traumatic brain injury. Brain injuries, which can also occur in the context of a skull fracture, are usually divided into three degrees of severity. A concussion represents the mildest form and in most cases heals without further consequential damage. In connection with a brain contusion, an injury to the tissues of the brain may result, with the risk of various late effects. The most severe and complicated form is cerebral contusion, in the context of which cerebral hemorrhage as well as permanent sequelae occur more frequently.
Causes
In the majority of cases, skull fractures occur as a result of direct and violent force. Very often they occur, for example, in connection with injuries during sports or traffic accidents. Often they occur in connection with the complication-rich craniocerebral traumas. However, numerous head injuries and skull fractures occur particularly in the workplace. In principle, the violent impact of force on the skull occurs in most cases in the form of a bump or blow to the head. On the one hand, it is possible that the head is in a still position and it is struck by a powerful external blow. On the other hand, it is possible that the head is in motion and is suddenly stopped by a hard object, such as a door, wall or floor. In all cases, the brain strikes the skull bone as it is pressed against the skull by the sudden change in motion. As part of a skull fracture, the meninges may tear. This occurs as a result of a particularly strong force, in which the skull bone breaks and injures the meninges. In such a case, it is an open craniocerebral injury. It is among the most serious head injuries of all.
Symptoms, complaints and signs
The symptoms of a skull fracture vary depending on the type of fracture. It is divided into skull base fracture, calvaria fracture as well as facial skull fracture.
- Facial skull fractures can occur, for example, in the form of zygomatic arch fractures, midface fractures, nasal bone fractures or blow-out fractures.
- Skull base fractures are divided into frontobasal, frontolateral as well as laterobasal fractures.
- A calvaria fracture is the fracture of the bone in the area of the so-called calvaria of the skull.
Basically, skull fractures result in swelling and heavy bleeding, because the skull has a good blood supply. In addition, bleeding from the ears and nose and visual disturbances often occur. Sometimes clearly visible steps form on the face and affected individuals complain of sensory disturbances under the eyelids. Skull fractures are associated with tremendous pain for patients.
Diagnosis and course of the disease
A number of investigative methods are available for reliable diagnosis of a skull fracture, depending on the severity and type of skull fracture.The basis for the diagnosis is always a physical examination of the affected patient. The skull is then subjected to an X-ray examination, with images being taken in two planes. Supplementary X-ray images of the temporomandibular joint or the paranasal sinuses, for example, are possible. In addition, the cervical spine is also examined by X-ray, with a so-called Dens target image being taken. This allows potential concomitant injuries to be diagnosed quickly. In addition, a computer tomogram of the skull is also possible, with the help of which fractures can be reliably detected. Various complications are conceivable in the course of a skull fracture. These include, for example, injuries to the brain and cranial nerves, cerebral hemorrhage, and infections ascending into the brain, such as encephalitis.
Complications
A skull fracture can be accompanied by complications. For example, it is not uncommon for concomitant injuries to occur. Whether a skull fracture causes sequelae depends on whether it is an uncomplicated or complicated fracture. If the fracture proceeds without concomitant injuries or displaced fracture fragments, healing takes only a few days to weeks. Otherwise, there is a risk of secondary damage. It is not uncommon for complications of a skull fracture to occur due to concomitant injuries. If, for example, the nose is affected, this can lead to problems with smelling or even to a total loss of the ability to smell. Impairment of the sense of taste is also possible. In most patients, these phenomena return to normal after some time, but chronic effects are sometimes possible. If nerves are affected as a result of the skull fracture, there is a risk of sensory disturbances or paralysis, the extent and position of which depends on the site that has suffered impairment. In addition, if the auditory canal is damaged, hearing impairment may occur, requiring surgical treatment. In some cases, however, permanent hearing impairment remains. Among the most severe effects of skull fracture is cerebral hemorrhage. In order for relief of the emerging pressure to occur, surgery must be performed immediately. Other complications of skull fracture include tearing of the dura mater, ascending infections, and inflammation of the brain (encephalitis).
When should you see a doctor?
A skull fracture must always be treated promptly by a doctor. This complaint, if left untreated, can lead to serious complications that can reduce and limit the person’s life expectancy. For this reason, a skull fracture requires first and foremost a very quick diagnosis and treatment in order to completely alleviate the discomfort. A doctor must be consulted if a fracture of the bone has occurred on the head or skull. In this case, very severe and violent swelling occurs on the head of the affected person, and the blood supply to the affected areas is also interrupted. The affected person suffers from very severe pain and visual disturbances. If these complaints occur, a doctor must be consulted in any case. Especially after a severe accident or after an injury a medical doctor must be contacted. Furthermore, a doctor should also be consulted if the affected person suffers from severe sensory disturbances. In the case of a skull fracture, a hospital should always be visited as a rule, although an emergency doctor can also be called in emergencies. The further course of this complaint depends very much on the exact extent of the fracture.
Treatment and therapy
A skull fracture is a sometimes life-threatening injury and requires immediate specialist treatment. Skull fractures are usually treated surgically. The only exceptions to this are linear calvarial fractures and nasal bone fractures. In the case of facial skull fractures, so-called intubation is considered to prevent aspiration. To treat mild skull fractures appropriately, a physician should be consulted for any head injury.
Prevention
Skull fractures caused by sports accidents in particular can often be prevented by wearing a protective helmet. In general, mindfulness during risky activities is recommended to prevent head injuries.
Aftercare
The person affected by a skull fracture often has only limited measures of direct aftercare available.Therefore, the affected person should ideally see a doctor at an early stage to avoid other complications or discomforts, as this may also not result in self-healing. In general, the early detection of the symptoms of a skull fracture is the main priority. Most of the affected persons are dependent on a surgical intervention, which should be performed as soon as possible. Therefore, in case of a skull fracture, the emergency physician should be called immediately. Furthermore, after such an operation, the affected person should in any case take it easy and rest, refraining from exertion or from stressful and physical activities in order not to put unnecessary strain on the body. Likewise, many of those affected are dependent on the help and support of their own family. Psychological support also has a very positive effect on the further course of the disease and can also prevent depression and other psychological upsets. In some cases, the skull fracture also limits the life expectancy of the affected person.
Here’s what you can do yourself
Patients with skull fracture are usually forced to stay in the hospital. During this time and afterwards, those affected must already take sufficient care of themselves. The affected area on the head should be padded with a soft pillow. In the morning and evening, the area should be carefully palpated and any symptoms recorded in a complaints diary. A facial fracture can cause severe headaches and other discomfort. For this, the doctor usually prescribes an analgesic. Patients must follow the doctor’s instructions regarding what to take and also make sure they have a regular sleep schedule. Because heavy work is not possible with a skull fracture, patients must call in sick to their job promptly. A simple skull fracture will heal within four to six weeks. Depending on the severity of the injury, additional measures may need to be taken. Physical therapy can be supported at home with moderate exercise. Cooling compresses help with acute pain. With the okay of the family doctor, various natural remedies can also be tried. Comfrey, for example, has a positive effect on the formation of bones. Bamboo contributes to bone healing due to its high silicea content. A diet rich in minerals ensures that the body has sufficient iron and calcium. If the skull fracture causes persistent discomfort or even bleeding, the doctor must be informed.