WHAT YOU NEED TO KNOW: What is a skull fracture? A skull fracture is a break in one or more bones in your child's head. The skull protects your child's brain, nerves, blood vessels, and inner ears from injury. What causes a skull fracture? A skull fracture is normally caused by an injury to the head. Skull fractures commonly occur from any of the following: - A hit on the head with an object
- Falls
- Motor vehicle accidents
- Sports or other activities
What are the signs and symptoms of a skull fracture? Signs and symptoms depend on the cause of your child's skull fracture. Your child's head may look misshapen. He may have headaches, dizziness, jaw pain, an upset stomach, or vomiting. Infants may have a bulging fontanelle (soft spot). Your child may also have any of the following: - A lump or swelling on the head
- Blood or clear fluid coming out of his nose or one or both of his ears
- Blurred or double vision
- Bruising behind the ears or around the eyes
- Increased sleepiness or confusion
How is a skull fracture diagnosed? - Neurologic signs, also called neuro signs, neuro checks, or neuro status, are used to check brain function. During a neuro check, a healthcare provider will check how your child's pupils react to light. He may check your child's memory and how easily he wakes up. His hand grasp and balance may also be tested. How your child responds to the neuro checks can show if his injury has affected his brain.
- X-rays may be used to check for broken bones and tissue swelling.
- A CT or MRI scan may be used to check your child's skull, brain tissue, and blood vessels. Your child may be given a dye to help his skull show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.
- A nasal CSF test is done to check for a cerebral spinal fluid (CSF) leak caused by a skull fracture. A test strip is used to collect fluid from your child's nose. The strip will show if the fluid is CSF or normal nasal drainage.
How is a skull fracture treated? Treatment will depend on the type of fracture your child has. Your child may need any of the following: - Medicines:
- Pain medicine may be given. Ask how often your child should get the medicine and how much he needs. Watch for signs of pain in your child.
- Diuretics are given to decrease fluid pressure in your child's head.
- Anticonvulsant medicine is given if your child's has seizures.
- Antibiotics are given to help prevent or treat an infection caused by bacteria. Your child may need antibiotics if the head injury caused an open wound.
- A neck brace may need to be worn to prevent your child from moving his head and neck.
- Irrigation and debridement is done when there is an open wound on the head. This helps to clean and remove objects, dirt, or damaged tissue from the fracture area.
- Surgery may be needed correct damage to your child's skull and surrounding tissue.
What should I do if my child has a head trauma? - Check if your child is breathing or has a pulse. Start CPR if needed. Have someone call 911 or a hospital for assistance.
- Do not move your child until there is medical help available. If your child is vomiting, turn him on his side by holding both sides of his head and shoulders while moving him. Do not allow his head and neck to bend, twist, or turn.
- Do not put anything into your child's mouth.
- Do not touch anything that is sticking out from his head.
- Apply direct pressure to your child's head if he is bleeding. Place another cloth on top of the first cloth if it becomes soaked with blood.
- If your child has a seizure, stay with him until the seizure ends. After the seizure, roll him onto his side. Do not move your child while he is having a seizure.
How can a skull fracture be prevented? - Always securely fasten your child in a car safety seat in the back seat.
- Do not leave your baby alone on any furniture, such as a bed or couch. Place him in a crib or playpen if you must leave him unattended.
- Do not let your child dive into a shallow pool or in water where the depth is not known.
- Make sure your child wears proper protective gear when he plays sports. Gear includes wrist guards, a helmet, kneepads, and a mouth guard that meet safety standards.
When should I contact my child's healthcare provider? - Your child has a fever.
- Your child's headache worsens even after you give him pain medicines.
- Your child is vomiting.
- You have questions or concerns about your child's injury, treatment, or care.
When should I seek immediate care or call 911? - Your child seems confused or more fussy, restless, or sleepier than usual.
- Your child has blood or fluid coming out of one or both ears.
- Your child is not hearing well, has slurred speech, or blurred vision.
- Your child has a seizure.
- Your child has weakness on one side of his body or trouble with balance.
- One of your child's pupils is larger than the other.
- Your child is suddenly dizzy and short of breath.
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