A skull fracture is a break in the bone surrounding the brain and other structures within the skull.
Types of skull fractures:
Compound Fractures: This term is used to describe fractures which are contaminated either internally with paranasal sinuses or externally with environment.
- Simple Linear
- Compound Linear
- Simple Depressed
- Compound Depressed
- Fractures of skull base.
Linear skull fracture: A common injury, especially in children, linear skull fracture is a simple break in the skull that follows a relatively straight line. It can occur after seemingly minor head injuries (falls; blows such as being struck by a rock, stick, or other object; or from motor vehicle accidents).
Role of Surgery: A linear skull fracture is not a serious injury unless there is an additional injury to the brain itself. However these injuries have to be carefully followed up, especially in infants and children, as these can give rise to GROWING SKULL FRACTURES later on in life. This is a rare complication of skull fracture seen in children younger than 3 years and occurs when a skull fracture fails to heal properly. Six or more months after the initial injury, the fracture may begin to widen instead of healing. Usually parents will notice swelling, which gradually increases in size. This is neither predictable nor preventable but should be treated by a neurosurgeon if it occurs. Swelling or masses noted in the first few weeks to months after a head injury in children are referred to as a "pseudo-growing fracture." They do not need treatment and will go away on their own but should be brought to paediatrician’s attention so they can be monitored.
Depressed skull fractures: These are common after forceful impact by blunt objects-most commonly, hammers, rocks, or other heavy but fairly small objects. These injuries cause "dents" in the skull bone.
Role Of Surgery: If the depth of a depressed fracture is at least equal to half the thickness of the surrounding skull bone (about 1/4-1/2 inch), surgery is often required to elevate the bony pieces and to inspect the brain for evidence of injury and repair the underlying dural tear which is often associated.
Fractures of Skull Base:
A fracture of the bones that form the base (floor) of the skull and results from severe blunt head trauma of significant force. A basilar skull fracture commonly connects to the sinus cavities. This connection may allow fluid or air entry into the inside of the skull and may cause infection.