Skull fractures occur frequently among active Americans. As a result, traumatic brain injuries (TBIs) are on the rise, affecting nearly 1.7 million people each year. In cases of moderate to severe brain injury, damage to the skull or cranial bone is common, typically resulting in skull fractures.
An average of 155 people in the U.S. died each day in 2014 from TBI-related injuries, according to the Centers for Disease Control and Prevention (CDC). The most recent studies from the CDC show that nearly 56,800 died of TBIs in 2014, and 288,000 were hospitalized with brain injuries. Many of these victims suffered skull fractures as well.
Types of Skull Fractures and Complications
A skull fracture is defined as a break or crack in the skull bone, often from a forceful trauma. The skull itself, though largely fused together as a single unit during the early years of life, is composed of 22 bones, of which only the jawbone or mandible moves on its own.
There are eight cranial bones protecting the brain and 14 facial bones, which together make up the skull. When trauma impacts any one of the cranial bones, the resulting fracture is typically named after the bone that broke. For instance, a parietal skull fracture refers to this quadrilateral-shaped bone with four angles. The same descriptive convention operates for the remaining cranial bones: the frontal, temporal, occipital, ethmoid, or sphenoid.
Like most severe injuries, skull fractures can lead to complications that may cause damage to surrounding areas, depending on their location in the cranial structure. For example, if a fracture forms at the base of the skull, the injury may damage surrounding nerves, arteries and more, reports the American Association of Neurological Surgeons (AANS). If a fracture forms in the sinuses, cerebrospinal fluid contained in the brain and spine may leak from the ears or the nose.
Another complication, intracranial hematomas (also known as blood clots) can be life-threatening, sometimes causing swelling or bleeding of the brain. Bleeding under the skull may also compress the brain as in a subdural or epidural hematoma.
- Linear skull fracture: The most common and typically least severe, a linear fracture is a break that does not shift the bone out of position. After a brief observation period in the hospital and a few days’ rest, the patient often is well enough to resume activities. A rare complication that can follow a linear skull fracture in children is a growing skull fracture, resulting in neurological and cranial defects.
- Basilar skull fracture: Far more serious, basilar, also called a basal skull fracture, is a break at the skull’s base or cranial vault often accompanied by bruises behind the ear and circling the eyes. If there’s clear liquid flowing from the ears or nose, that may signal a tear in a portion of the brain’s covering. These patients can expect to be closely watched in the hospital for any deterioration.
A rare type of basilar skull fracture is the occipital condylar fracture, impacting the occipital bone in the lower back of the skull. It is seen in just 3-4 percent of those with severe to moderate TBI. Caused by a high-energy trauma—predominately a car accident—occipital fractures can result in cranial nerve palsies and cervical spine instability.
- Depressed skull fracture: When trauma collapses part of the skull, it may require surgery to fix the abnormality. This fracture is sometimes accompanied by a cut in the scalp. When the depression is long, narrow, and caused by a gunshot wound, doctors call it a gutter fracture. When the fracture impacts newborns and older children, the term may be ping-pong ball fracture, aka pond fracture, often an indication of TBI. This closed fracture is caused by labor and obstetric trauma in newborns and direct head trauma in older kids, often requiring surgery.
- Diastatic skull fracture: Infants are most likely to see a diastatic skull fracture right at the suture lines in the skull, where the bones in the head fuse in childhood. The result may be a widening of the suture lines.
Injuries also can be classified as a comminuted skull fracture when accompanied by three or more broken sections of bone, an open skull fracture or compound skull fracture if the skin is torn, or a closed skull fracture (aka simple fracture) if not associated with a break in the skin.
Skull Fracture Causes
It takes a substantial force to break the skull bone—the type of blow often associated with falls, car crashes, physical violence, and athletics. Baby skull fractures typically result from an accidental fall, child abuse, or medical malpractice if the skull fracture occurred during delivery. Since babies are born with soft skulls, not yet fully developed, they can be particularly vulnerable to skull fractures, sometimes leading to long-term brain damage. Teens are another group prone to skull fractures, most commonly forming from injuries related to dangerous sports and activities like football and skateboarding.
Skull Fracture Symptoms
The most obvious signs of a skull fracture requiring immediate medical care are:
- Confusion and distress
Just as critical are any of the following:
- Bleeding from the wound, ears, nose, or eye area
- Swelling, bleeding, or bruising
- Clear or bloody liquid leaking from the ears or nose
There are other less-obvious symptoms that also shouldn’t be ignored. For example, the injured party may be struggling to keep their balance, drowsy, or suffering from a headache or stiff neck. They may be vomiting or nauseous, restless, irritable, or slurring their speech. All these signs point to a skull fracture.
Visual Indications of a Skull Fracture
Another potentially serious symptom is the presence of a “battle sign:” a large bruise across the back of the ear, sometimes stretching to the upper neck, and possibly accompanied by raccoon eyes or bruising around the eyes.
Visual disturbances are another red flag that can be detected by checking to see if the victim’s pupils are unreactive to light and/or unequal in size. A skull fracture also can present itself within 24 hours as simply a bruise or bump on the head.
In any case, any visual indication of a potential skull fracture should always be checked by a medical professional as soon as possible. Even if a person seems to be relatively uninjured and behaving normally, finding these visual cues may indicate that a skull fracture has formed with the potential to cause complications which can lead to severe damage. Immediate medical attention may prevent these complications, and significantly increase one’s rate of recovery.
Signs of Skull Fractures in Infants
In a baby, signs of a mild fracture include irritability, seizures, lethargy, crying, difficulty sleeping or nursing, sensitivity to lights and sounds, and abnormal eye movement. A severe skull fracture in an infant includes swelling, lump, or depression; bruising around the eyes; and fluid from the nose and ears.
Emergency First Aid Protocol for Skull Fractures
Here are the emergency steps to take for a skull fracture while waiting for the ambulance to arrive after calling 911:
- Determine whether the victim needs CPR. A severe skull fracture may obstruct the airways, hindering breathing and circulation.
- Since head injuries can be related to spinal cord injuries, avoid moving the victim. Moving the individual could aggravate the injury. If it’s absolutely necessary to move the person, make certain to provide stability with hands on both sides of the head and under the shoulders. Do not allow the head to bend, twist, or turn.
- In the event of bleeding, apply firm pressure with a clean cloth. Do not remove the cloth if it gets soaked. Instead apply more clean cloths over the top and continue pressure. The Mayo Clinic does not recommend direct pressure when a skull fracture is suspected.
- If vomiting occurs, stabilize the head and neck to turn the individual on their side as a precaution against choking.
- Check the injury site with extreme care. Do not probe inside the wound or removing anything sticking out of it.
- Do not allow the victim to resume activities, regardless of their appearance. Even if they do not look ill, keep close watch and restrict their movement as much as possible.
Never administer any medicine unless prescribed by a doctor.
Treatment for Skull Fractures
Many skull fractures heal on their own over a period of about six weeks, but some require surgery—especially if brain injury is involved. For example, basal fractures with excess leakage of cerebrospinal fluid or a depressed fracture that is sunken severely typically require brain surgery and can take much longer to heal than more moderate types of skull fractures.
Severe head injuries are typically treated at a hospital, such as the New York-Presbyterian in the Hudson Valley or Montefiore Medical Center in the Bronx, as they typically have more of the resources necessary for diagnosing and treating skull fractures than smaller clinics that are.
Doctors may diagnose a skull fracture by physical examination, or with the help of a 3-D imaging tool like a CAT scan. If a leak from the brain or spinal cord is suspected, he or she could detect it through a process of a blood test. This particular test may indicate the presence of cerebrospinal fluid in the blood, and can point them to the location of the leak.
A potentially serious injury like a skull fracture invites the question of legal compensation especially if the break occurred on the job or from another’s negligence as in a car or medical accident. Not every skull fracture is cured quickly. In fact, about 25 percent of those with moderate head injuries become disabled according to the AANS. The best way to explore all the options is to check with an attorney experienced in personal injury cases.
Skull Fracture Lawsuits & Compensation
When skull fractures occur due to the negligence of a third party, injured victims may be eligible for compensation. Filing a personal injury lawsuit can help injured victims obtain settlements that can cover lost wages from being out of work, medical and physical therapy costs, reparations for pain and suffering, and other damages.
If you or a loved one is suffering from a skull fracture due to the negligence of another party, you are entitled to a free consultation with the personal injury lawyers at Sobo & Sobo by calling 855-468-7626, or via online messaging. Our attorneys have over 50 years of experience helping skull fracture victims win the compensation and justice they deserve.
Skull fracture attorneys are available in locations throughout New York City and the Hudson Valley. Find the closest office location to you, and let us help you determine the value of your skull fracture lawsuit.