In case of an urgent concern or emergency or if you believe your child has a skull fracture, call 911 or go to the nearest emergency department right away.

What is a skull fracture?

The skull is made up of many small bones. It covers and protects the brain. A skull fracture is a break in one or more of these bones.

Types of skull fractures

There are four main types of skull fractures. Your child’s doctor at Children’s Healthcare of Atlanta will help identify the type of skull fracture your child has:

  1. A linear skull fracture is the most common type of skull fracture. It causes a break in the bone that looks like a thin line. The bone itself does not move. Children with this type of fracture usually have a short hospital stay, and surgery is usually not needed.
  2. A depressed skull fracture happens when part of the skull bones press inward on the brain. Surgery may be needed to prevent damage to the brain. Doctors repair the break by lifting pieces of the bone back into their usual place.
  3. A diastatic skull fracture occurs along the suture lines in the skull and is more common in newborns and babies. Suture lines are the spaces in between the skull bones. They make room for the brain to grow, and as children grow, the spaces get smaller.
  4. A basilar skull fracture is the most serious type of skull fracture. It is a break in the bone in the back of the head and at the bottom of the skull. It can cause bruises around the eyes and behind the ears. Cerebrospinal fluid (CSF) is a clear liquid that surrounds and cushions the brain, and it might drain from the nose with this type of fracture.

What are symptoms of a skull fracture?

Skull fracture symptoms may include:

  • Small cut, bruise or swelling of the head (up to 24 hours to see bruises and bumps)
  • Pain or tenderness at the site of injury
  • Headache
  • Upset stomach
  • Vomiting
  • Sensitivity to noise and light
  • Increased fussiness
  • Inability to remember the event
  • Dizziness or loss of balance

More severe skull fracture symptoms may include:

  • Headache that does not go away
  • Nausea or vomiting that does not go away
  • Inability to concentrate or remember
  • Slurred speech
  • Trouble walking
  • Weakness on one side or area of the body
  • Clear fluid or blood leaking from nose or ear
  • Bruises around the eyes
  • Bruises behind the ears
  • Ringing in the ears
  • Trouble seeing
  • Fainting
  • Seizure
  • Problems waking up
  • Coma

How is a skull fracture treated?

At Children’s, our team is specially trained to help treat children, teens and young adults who have suffered a skull fracture. Mild skull fracture treatments may include:

  • Ice
  • Rest
  • Medicines by mouth to help with discomfort
  • Ointment for small cuts and scrapes
  • Stitches for larger cuts
  • Observation in the hospital for 24 to 48 hours

More severe skull fracture treatments, in addition to treatments for mild skull fractures, may include:

  • Oxygen
  • Special monitoring for increased pressure inside the skull in a pediatric intensive care unit (PICU)
  • Medicines and fluids through an I.V.
  • Surgery
  • Rehabilitation

Other treatments may be administered to:

  • Support breathing, blood pressure and the heart.
  • Reduce brain swelling.
  • Prevent or stop seizures.
  • Fight infection.
  • Stop an upset stomach and vomiting.
  • Relieve pain and discomfort.

Follow-up treatment

Healing time for a skull fracture depends on the type of fracture and its severity. Skull fractures can take three to six months to heal completely. They usually heal faster in younger children. Have your child avoid rough sports until the doctor tells you it is OK to begin again. Your child may need a follow-up CT scan to make sure the skull fracture is healing properly.

If you are concerned about your child after a suspected and/or confirmed skull fracture, call 911 or go to the nearest emergency department right away.

Most children with mild skull fractures can be cared for at home after being watched in the hospital for the first 24 to 48 hours. After your child goes home, call a doctor right away if he:

  • Is not eating or drinking well.
  • Vomits more than twice.
  • Has trouble seeing.
  • Acts differently than usual, such as avoiding play, acting fussy or seeming confused.
  • Cannot think clearly or remember things.
  • Has a severe headache.
  • Has clear fluid or blood coming from his nose or ears.
  • Is hard to wake up.
  • Is clumsy, dizzy or unsteady.
  • Has weakness in the arms or legs or does not move them as usual.
  • Has slurred speech.
  • Has a seizure.