Understanding Skull Fracture

Types of skull fracture

There are several 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 doesn't 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 1 to 3 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.

• Elevated skull fracture. The fracture fragment is raised (elevated) above the underlying skull bone. These are uncommon.

What causes a skull fracture?

The most common causes of skull fracture in adults are:

• Falling.

• Motor vehicle crashes.

• Being hit with an object.

• Physical assault.

• Sports injuries.

Symptoms of a skull fracture

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.

• Headaches.

• 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 the ears or nose.

Diagnosing a skull fracture

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

• A 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 bones, blood, and injuries to the brain.

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

• An 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 for skull fracture

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

Or you may be watched for a few hours or days 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 doctor will tell you more if you need medicines. 

When to call your doctor 

Contact your doctor right away if you have:

• Nausea.

• An unexplained fever.

• A headache that won’t go away.

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

Call 911

Call 911 if you have:

• Confusion.

• A seizure.

• Vomiting.

• Severe tiredness.

• A severe headache.

• Dizziness.

• Weakness or numbness.

• Blood or fluid leaking from your nose or ear.

• Loss of consciousness.

• Vision problems.

• Trouble walking.