Skull Fracture

What is a skull fracture?  

A skull fracture is a break in the skull bone. There are six types of skull fractures:  

• linear,  
• depressed,  
• open,  
• diastatic,  
• growing, and  
• basilar.  

The most common type of fracture in young children and adolescents is a linear skull fracture, while diastatic skull fractures (occur along the suture lines of the skull causing widening of the sutures) are more common in infants. Typically, skull fractures are treated with pain management and close follow-up with a trained provider. Sometimes, surgery is needed to fix the facture. H Open and depressed skull fractures are more likely to require surgery than other types of skull fractures.   

What causes a skull fracture? 

A skull fracture is caused by a traumatic injury to the head that causes a break in the skull bone. The most common types of injuries that cause skull fractures are sports-related injuries, falls, motor vehicle accidents, or, unfortunately, in circumstances of child abuse.   

What are the signs of a skull fracture?  

• Headaches 
• Head pain or tenderness 
• Palpable bony abnormalities or “step-offs” over the area of injury 
• Swelling or bruising of the scalp 
• Bruising around the eyes or behind the ears 
• Blood or clear fluid draining from the ears or nose 
• Concussion symptoms may be present  with a skull fracture including, but not limited to, light or sound sensitivity, nausea or vomiting, and fatigue 

How is it diagnosed? 

X-rays or a head CT (computed tomography) are used to  look for a skull fracture and any scalp or intracranial injuries such as bleeding in the brain.  If there is concern for an intracranial injury,  an MRI (magnetic resonance imaging) may be ordered. 

How should I care for my child? 

Rest, activity modification, and pain control are the best ways to care for a skull fracture. A neurosurgical provider will make recommendations on when it is okay to resume normal activity for the patient's age as well as any contact sports. It is not uncommon for patients to have a concussion in association with a skull fracture and a concussion consultation may be recommended. In rare circumstances, a skull fracture may require neurosurgical intervention if the bone edges are not well aligned, the fracture is depressed, or there is an open wound overlying the fracture. Post-operative care in such circumstances will be reviewed by a neurosurgical provider.   

When should I call the clinic? 

Following a skull fracture diagnosis, call the clinic for:   

• New or worsening headaches 
• Vomiting 
• Vision changes 
• Abnormal sleepiness 
• Abnormal irritability or increasing discomfort 
• New bruising or swelling 
• Weakness in the face or extremities 
• Blood or clear fluid is seen draining from the ears or nose 
• A concern for seizure activity 

What else do I need to know? 

Skull fractures are incredibly common in children and the prognosis is usually very good. Unless there are significant injuries, which a provider would inform you about, your child should heal well and be able to live a very normal life without any long-term difficulties.   

Questions? 

This information is not specific to your child but provides general information. If you have any questions, please call your clinic. 

Reviewed 9/2023

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