Skull fracture

(Redirected from Skull Fracture)

This page is for adult patients. For pediatric patients, see: skull fracture (peds).


Bones of the cranium.
  • Presence of skull fracture significantly increases risk of underlying intracranial injury

Clinical Features

Linear Skull Fracture

  • Often have scalp hematoma or tenderness to palpation

Depressed Skull Fracture

  • Depression or crepitus may be palpable on physical exam

Basilar Skull Fracture

  • Raccoon eyes
  • Battle sign
  • Hemotympanum
  • Clear rhinorrhea or otorrhea may indicate CSF leak from dural tear associated with fracture

Differential Diagnosis

Head trauma

Maxillofacial Trauma


Computed tomography of a left-sided depressed skull fracture and associated subdural hematoma over the temporal region.
  • CT head
  • CBC
  • Coags
  • Evaluate for additional injuries


Linear Skull Fracture

  • If no intracranial bleed or other injuries, observe for 4-6 hrs and discharge
    • Patients with advanced age, coagulopathy, or other co-morbidities may benefit from admission

Depressed Skull Fracture

  • Neurosurgery consult
  • Antibiotics, seizure prophylaxis (e.g. Keppra), surgery/wound debridement may be indicated in discussion with a neurosurgeon

Basilar Skull Fracture

  • Neurosurgery consult
  • Antibiotic prophylaxis is often started in setting of CSF leak but should be discussed with a neurosurgeon


  • Admit - except for simple linear skull fracture with no other injuries

See Also

External Links