Understanding Skull Fracture (Child)

A skull fracture is a type of head injury. It's a break in the bone that surrounds the brain. A skull fracture can occur with or without brain damage.

Side view of child's head showing skull.

Types of skull fracture

There are several types of skull fractures:

  • Linear skull fracture. This is a break in the bone, but it doesn't move the bone. In many case, no treatment is needed. A child can go back to normal activities in a few days.

  • Depressed skull fracture. Part of the skull is sunken in from the injury. If the inner part of the skull is pressed against the brain, this needs treatment right away with surgery.  

  • Diastatic skull fracture. This kind of fracture occurs along the suture lines in the skull. These are the areas between the bones in the head that grow together (fuse) as a child grows. With this type of fracture, the suture lines are widened. This type of fracture is more common in newborns and young babies.

  • Basilar skull fracture. This is a break in the bone at the base of the skull. It can be a serious type of skull fracture. Children with this type of fracture often have bruises around their eyes and a bruise behind their ear. They may also have clear fluid draining from their nose or ears. This is because of a tear in part of the covering of the brain.

  • Growing skull fracture. This is a rare complication of skull fractures. It almost always occurs in children younger than age 3. It's a fracture that becomes wider over time because of an enlarging cyst.

What causes a skull fracture?

The most common causes of skull fracture in children are:

  • Falls

  • Outdoor activities

  • Sports

  • Physical assault

  • Motor vehicle accidents

Boys tend to have traumatic head injuries more often than girls. These kinds of injuries are more common in spring and summer months, when children are active outdoors. Activities, such as bike riding, in-line skating, or skateboarding, can cause injury. Many of these injuries can be prevented by wearing the correct helmet the right way.

Symptoms of a skull fracture

The symptoms of a skull fracture can include:

  • Confusion

  • Trouble with balance

  • Sleepiness

  • Headache

  • Changes in pupil size

  • Bump on the head

  • Bleeding from a head wound

  • Restlessness or irritability

  • Stiff neck

  • Vision changes

  • Slurred speech

  • Nausea and vomiting

  • Loss of consciousness

  • Seizures

  • Bruising behind the ears or under the eyes

  • Clear or bloody fluid draining from ears or nose

The severity of symptoms can vary. They depend on how serious the injury is.

Diagnosing a skull fracture

The healthcare provider will ask about your child’s health history and symptoms. They'll ask about recent accidents or injury. Your child will have a physical exam. Your child may also have tests, such as:

  • Blood tests. These are done to check for signs of infection and other problems.

  • X-ray. This test uses a small amount of radiation to create images of bones and other parts of the body.

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

  • CT scan. This test uses a series of X-rays and a computer to created detailed images of the body. This test can show broken bone, as well as injury to the brain.

Online Medical Reviewer: Joseph Campellone MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Rita Sather RN
Date Last Reviewed: 7/1/2021
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