Skull fractures in children
- Alison Chantal Caviness, MD, MPH, PhD
Alison Chantal Caviness, MD, MPH, PhD
- Associate Professor of Pediatric Emergency Medicine
- Baylor College of Medicine
- Section Editor
- Richard G Bachur, MD
Richard G Bachur, MD
- Section Editor — Pediatric Trauma
- Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Skull fractures result from direct impact to the calvarium and are important because of their association with intracranial injury, the leading cause of traumatic death in childhood [1,2]. Every year, more than 600,000 children visit emergency departments in the United States for blunt head trauma; approximately 95,000 of them have intracranial injuries, and 5700 die as a result of those injuries [3-5]. The morbidity and mortality from head injuries is increased when associated extracranial injuries are present [6,7].
The epidemiology, clinical features, complications, and management of skull fractures are reviewed here. Closed head injury and nonaccidental head trauma are discussed separately. (See "Minor head trauma in infants and children: Evaluation" and "Child abuse: Epidemiology, mechanisms, and types of abusive head trauma in infants and children".)
The incidence of skull fractures in children who present for outpatient evaluation of head trauma ranges from 2 to 20 percent . The parietal bone is involved most frequently, followed by the occipital, frontal, and temporal bones. Linear fractures are most common, followed by depressed and basilar fractures.
The causes of skull fracture and the causes of head injury typically are not separated in the literature except for infants, who are at increased risk of skull fractures from minor mechanisms of trauma [9-11]. The major causes of head injuries in children are :
●Falls – 35 percent
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- - Comminuted
- CLINICAL MANIFESTATIONS
- Linear skull fracture
- - Complications
- Depressed skull fracture
- Basilar skull fracture
- - Complications
- Growing skull fracture
- RADIOLOGIC EVALUATION
- Skull radiographs
- Computed tomography
- Isolated skull fractures
- Open skull fractures
- Basilar skull fractures
- Depressed skull fractures
- Growing skull fractures
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS