Depressed Skull Fracture
A skull fracture happens when a force sufficiently strong enough to break the bone strikes the skull. We see this type of injury when someone falls and hits their head on the ground, during a car accident, or any other form of head trauma. A depressed skull fracture is considered a traumatic injury.
What is a Depressed Skull Fracture?
A depressed skull fracture is a common traumatic head injury that physicians come across. The symptoms and severity of this injury varies widely depending on the circumstances. When physicians classify skull fractures, a depressed skull fracture has to meet a few criteria for proper diagnosis:
- A fracture has been identified in the skull surface
- This fracture has been depressed from the skull towards the brain surface
These fractures vary widely in size and location. This fracture may also splinter into multiple pieces.
What is the Injury Mechanism?
Almost every depressed skull fracture is the result of a traumatic event such as a car accident. It is not unusual for people to have sudden changes of momentum during a car accident. The head can collide with the dashboard of windshield. Sometimes, objects will crash through the glass and strike the driver or passenger. When a person’s head collides with a blunt object at high speed, this can create a depression in the skull that breaks the bone in the process.
What is the Approach to Treatment?
Prior to a decision on treatment, the physician will take several different factors into account. These include:
- How bad are the patient’s symptoms?
- What are the associated injuries?
- How large is the fracture?
- Where is the fracture located?
Some fractures are only a few millimeters in length. These may not require surgery; however, almost every depressed skull fracture requires surgery to correct. The surgeon will place the skull back in line with the rest of the skull. The surgeon may also use plates or screws to hold the bone in place during the healing process.
What are the Complications that can Develop from a Depressed Skull Fracture?
Almost every patient will have severe pain and a headache at the site of the injury. Bleeding will also range in severity. Most of the severe complications will result from the fracture location. This could lead to difficulty seeing or hearing. The patient may also be confused depending on either the presence or absence of underlying brain damage.
Could Other Structures be Damaged?
The brain is home to a myriad of important brain structures that could be damaged if impacted by a piece of bone from the fracture. Examples include:
- Vital nerves, including the optic nerve, ophthalmic nerve, and facial nerve
- Important arteries that supply blood to the brain
- The brainstem
- The ventricles of the brain
- The patient’s spine
These are all parts of the central nervous system that perform vital functions that are essential to life. If any of these are damaged, the patient could wind up with severe disabilities. Some could lead to fatal complications.
What is the Differential Diagnosis?
When a patient sustains a head injury, a depressed skull fracture is only one possible diagnosis. There are multiple other possible diagnoses including:
- Linear skull fracture
- Concussion
- Cerebral contusion
- Intracerebral hemorrhage
- Epidural hematoma
- Stroke
The physician will use the patient’s symptoms, physical exam, and various imaging modalities to correctly diagnose the condition.
What is the Prognosis?
There are multiple factors that a healthcare professional will take into account when deciding on the prognosis. This includes the size, location, and other associated injuries. Some patients will make a full recovery in a few weeks while other patients could become disabled for life. This is determined on a case by case basis.
When Might a Patient Need Surgery?
Almost every patient suffering a depressed skull fracture requires surgery. For fractures to heal properly, the bone must be in contact with the other pieces. In a depressed skull fracture, the bone is out of alignment with the rest of the skull by definition. Therefore, surgery is required to set the bone and facilitate a proper healing process.
Davis Personal Injury & Car Accident Lawyers
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Image Attribution: [Public Domain Images – Wikimedia Commons] National Institutes of Health, Health & Human Services
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