Skull fractures in children: Clinical manifestations, diagnosis, and management
- Shireen Atabaki, MD, MPH, FAAP
Shireen Atabaki, MD, MPH, FAAP
- Vice Chair, Institutional Review Board
- Director, Medical Student Education
- Associate Professor of Pediatrics & Emergency Medicine
- George Washington University School of Medicine and Health Sciences
- Children's National Health System
- 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 — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
The clinical manifestations, diagnosis, and management of skull fractures in children are reviewed here.
The approach to severe traumatic brain injury in children and skull fractures in children with inflicted injury is discussed separately. (See "Severe traumatic brain injury in children: Initial evaluation and management" and "Child abuse: Evaluation and diagnosis of abusive head trauma in infants and children", section on 'Skeletal evaluation'.)
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. 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 [2-4]. The major causes of head injuries in children are :
●Falls – 35 percent
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- - Comminuted
- CLINICAL MANIFESTATIONS
- Linear skull fracture
- Depressed skull fracture
- Basilar skull fracture
- Growing skull fracture
- DIAGNOSIS AND RADIOLOGIC EVALUATION
- INDICATIONS FOR SPECIALTY CONSULTATION
- Brain injury and major trauma
- Isolated skull fractures
- - Complications
- Open skull fractures
- Basilar skull fractures
- - Complications
- Depressed skull fractures
- Growing skull fractures
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS