Skull fractures

Skull fractures are most commonly caused by a fall, a road traffic accident, or an assault.

Skull fractures may be linear or comminuted with multiple fracture lines, may be located on the cranial vault or in the basilar skull, may have a varying degree of depression or elevation, and can be open or closed. Open fractures communicate with the skin through a wound, a sinus, the ear, or the oropharynx.

Computed tomography (CT), with thin axial cuts, remains the imaging modality of choice, if indicated. With basilar skull fractures, three-dimensional reconstructions are useful.

May be associated with other significant injuries, most importantly intracranial haemorrhage.

For isolated skull fractures, treatment is primarily conservative.

Surgical intervention is determined not by the fracture per se but by extent of associated intracranial pathology, cranial nerve deficit, or cerebrospinal fluid leak.

Skull fractures refer to fractures of one or more bones of the cranial vault or skull base. They are categorised according to the appearance, location, degree of depression, and according to whether they are open or closed. Open fractures communicate with the skin through a wound, a sinus, the ear, or the oropharynx. Skull fractures may be linear or comminuted; comminuted fractures are complex with multiple fracture lines.