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Diastatic skull fractures. These are fractures that occur along the suture lines in the skull.

WHAT YOU NEED TO KNOW:

The sutures are the areas between the bones in the head that fuse when we are children. In this type of fracture, the normal suture lines are widened. These fractures are more often seen in newborns and older infants. Basilar skull fracture. This is the most serious type of skull fracture, and involves a break in the bone at the base of the skull. Patients with this type of fracture frequently have bruises around their eyes and a bruise behind their ear.

They may also have clear fluid draining from their nose or ears due to a tear in part of the covering of the brain. These patients usually require close observation in the hospital. Intracranial hematoma ICH. There are several types of ICH, or blood clots, in or around the brain. The different types are classified by their location in the brain. These can range from mild head injuries to quite serious and potentially life-threatening injuries.

Early diagnosis and treatment of growing skull fracture.

The different types of ICH include the following:. Epidural hematoma. Epidural hematomas occur when a blood clot forms underneath the skull, but on top of the dura, the tough covering that surrounds the brain. They usually come from a tear in an artery that runs just under the skull called the middle meningeal artery. Epidural hematomas are usually associated with a skull fracture. Subdural hematoma. Subdural hematomas occur when a blood clot forms underneath the skull and underneath the dura, but outside of the brain.

These can form from a tear in the veins that go from the brain to the dura, or from a cut on the brain itself. They are sometimes, but not always, associated with a skull fracture. Contusion or intracerebral hematoma. A contusion is a bruise to the brain itself. A contusion causes bleeding and swelling inside of the brain around the area where the head was struck.

Contusions may occur with skull fractures or other blood clots such as a subdural or epidural hematoma. Bleeding that occurs inside the brain itself also called intraparenchymal hemorrhage can sometimes occur spontaneously. When trauma is not the cause, the most common causes are long-standing, high blood pressure in older adults, bleeding disorders in either children or adults, or the use of medications that cause blood thinning or certain illicit drugs. Diffuse axonal injury DAI. These injuries are fairly common and are usually caused by shaking of the brain back and forth, which can happen in car accidents, from falls or shaken baby syndrome.

Diffuse injuries can be mild, such as with a concussion, or may be very severe, as in diffuse axonal injury DAI. In DAI, the patient is usually in a coma for a prolonged period of time, with injury to many different parts of the brain. There are many causes of head injury in children and adults. The most common traumatic injuries are from motor vehicle accidents automobiles, motorcycles, or struck as a pedestrian , from violence, from falls, or as a result of child abuse. Subdural hematomas and brain hemorrhages called intraparenchymal hemorrhages can sometimes happen spontaneously.

When there is a direct blow to the head, shaking of the child as seen in many cases of child abuse , or a whiplash-type injury as seen in motor vehicle accidents , the bruising of the brain and the damage to the internal tissue and blood vessels is due to a mechanism called coup-countrecoup.

Understanding Traumatic Brain Injury

As the brain jolts backwards, it can hit the skull on the opposite side and cause a bruise called a countrecoup lesion. The jarring of the brain against the sides of the skull can cause shearing tearing of the internal lining, tissues, and blood vessels that may cause internal bleeding, bruising, or swelling of the brain.

The person may have varying degrees of symptoms associated with the severity of the head injury. The following are the most common symptoms of a head injury. However, each individual may experience symptoms differently.

Skull Fracture

Symptoms may include:. Moderate to severe head injury requires immediate medical attention --symptoms may include any of the above plus:. Loss of short-term memory, such as difficulty remembering the events that led right up to and through the traumatic event. Coma a state of unconsciousness from which a person cannot be awakened; responds only minimally, if at all, to stimuli; and exhibits no voluntary activities.

Vegetative state a condition of brain damage in which a person has lost his thinking abilities and awareness of his surroundings, but retains some basic functions such as breathing and blood circulation. Locked-in syndrome a neurological condition in which a person is conscious and can think and reason, but cannot speak or move. The symptoms of a head injury may resemble other problems or medical conditions. The full extent of the problem may not be completely understood immediately after the injury, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a head injury is made with a physical examination and diagnostic tests.

During the examination, the doctor obtains a complete medical history of the patient and family and asks how the injury occurred.

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Trauma to the head can cause neurological problems and may require further medical follow up. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.

CT scans are more detailed than general X-rays. Growing skull fracture in an adult nine years after blunt head trauma. J Clin Neurosci ; Singla N, Gupta SK. The natural history of an untreated growing skull fracture: An unusual case. Pediatr Neurosurg ; Cranioplasty for repair of a large bone defect in a growing skull fracture in children. J Craniomaxillofac Surg ; The natural history of late diagnosed or untreated growing skull fractures: Report on two cases. Use of magnetic resonance imaging to identify the edge of a dural tear in an infant with growing skull fracture: A case study.

Child Nerv Syst ; Growing skull fracture with cerebral and ventricular hernia after brain trauma. Dakar Med ; Growing skull fracture in childhood. Presentation of 12 cases. Neurocirugia Astur ; Singhal A, Steinbok P.


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Operative management of growing skull fractures: A technical note. Childs Nerv Syst ; The growing skull fracture, a rare complication of paediatric head injury. Eur J Pediatr ; Growing skull fractures of childhood. I Neurosurg ; Sanford RA. Prevention of growing skull fractures: Report of 2 cases. J Neurosurg Pediatr ; Growing skullbase fracture: A case report with special reference to its pathogenesis.

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Brain Nerve ; Growing skull fracture after minor closed-head injury. J Pediatr ; Growing skull fractures: A clinical study of 41 patients. Child neurology: A growing skull fracture. Neurology ;e Growing skull fracture stages and treatment strategy. Case report and review of cases. J Neurosurg Sci ; The value of MRI in the early diagnosis of growing skull fracture. Pediatr Radiol ; Intrauterine head stab wound injury resulting in a growing skull fracture: A case report and literature review. Large intradiploic growing skull fracture of the posterior fossa. Growing skull fractures.