Skull Fractures

Maj Hemstad
A skull fracture is a type of injury often seen with moderate or severe TBI, although skull fractures can occur without the brain being injured. Dr. Freeman, what can you tell us about skull fractures?

Dr. Freeman
Well, Dr. Hemstad, a skull fracture is a crack or break in the bones of the skull, also called the cranial bones. Although the skull is hard and usually provides excellent protection for the brain, a severe impact or blow can cause a fracture.

There are several types of skull fractures, including:

• Simple
• Linear
• Compound 
• Depressed, and
• Penetrating

A simple skull fracture is a break in the skull without damage to the surrounding skin. A linear skull fracture is a break in the skull that looks like a thin line, without any additional damage to the bone. Compound skull fractures refer to splintering of the bone. When a broken or "crushed" portion of the skull presses in towards the brain, it’s called a depressed skull fracture. When an object, such as a bullet or debris from an explosion, pierces the skull, a person has a penetrating skull fracture.

Most simple skull fractures heal on their own and without medical intervention. However, if the fracture is accompanied by hematoma, or bleeding, in or around the brain, surgery may be required to relieve pressure on the brain. Additionally, if the skin is broken and the injury site contaminated, a provider may prescribe antibiotics to prevent or fight infection.