Depressed skull fracture
Last revised by Tom Foster on 2 Nov 2019
Citation, DOI, disclosures and article data
Citation:
Bickle I, Foster T, Hacking C, et al. Depressed skull fracture. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-29691
Permalink:
rID:
29691
Article created:
13 Jun 2014,
Ian Bickle ◉
Disclosures:
At the time the article was created Ian Bickle had no recorded disclosures.
View Ian Bickle's current disclosures
Last revised:
2 Nov 2019,
Tom Foster ◉
Disclosures:
At the time the article was last revised Tom Foster had no recorded disclosures.
View Tom Foster's current disclosures
Revisions:
10 times, by
6 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Depressed skull fractures
Depressed skull fractures result in the bone of the skull vault being folded (depressed) inward into the cerebral parenchyma. It is usually the result of a high energy impact to the skull.
On this page:
Pathology
These mostly (~75%) occur in the frontoparietal region 3.
Associations
There are a number of associated injuries with depressed skull fractures 1,2:
- extradural haematoma
- subdural haematoma
- cerebral contusion
- subarachnoid haemorrhage
- pneumocephalus
- CSF leak
Radiographic features
Plain radiograph
Rarely undertaken, especially outside of the paediatric population. The fracture is identified due to the projection of dense bone over the skull.
CT
The modality of choice in head trauma. The fracture is shown in detail along with any associated injuries.
Treatment and prognosis
There are a number of indications for operative management, these include 2-4:
- dural breach, increased risk if >5 mm depression from inner table
- depression >5-10 mm
- significant intracranial haemorrhage
- frontal sinus involvement
- significant wound contamination or cosmetic deformity
- pneumocephalus
Depressed skull fracture are associated with higher rates of infection (~10%), seizure (~15%), neurological deficits, and death 3.
References
- 1. Brant WE, Helms CA. Fundamentals of Diagnostic Radiology. Lippincott Williams & Wilkins. (2007) ISBN:0781761352. Read it at Google Books - Find it at Amazon
- 2. Pope TL. Harris & Harris' Radiology of Emergency Medicine. Lippincott Williams & Wilkins. (2012) ISBN:145110720X. Read it at Google Books - Find it at Amazon
- 3. The Neurosurgeon's Handbook. Oxford University Press. ISBN:0198570678. Read it at Google Books - Find it at Amazon
- 4. Kaye. Essential Neurosurgery. John Wiley & Sons. (2009) ISBN:1405148179. Read it at Google Books - Find it at Amazon
Incoming Links
Articles:
Cases:
- Depressed skull fracture
- Ping pong skull fracture
- Multifocal orbital and calvarial fractures
- Orbital roof blow-in fracture
- Skull fracture
- Epidural hematoma with depressed skull fracture
- Traumatic brain injury with depressed skull fracture
- Depressed skull fracture
- Depressed skull fracture with extradural haematoma
- Penetrating head injury
- Paediatric ceiling fan-induced head injury
- Depressed frontal fracture
- Intraparenchymal haemorrhage and pneumocephalus
- Extradural haemorrhage
- Traumatic brain injuries
- Depressed fracture of the frontal sinuses due to head butt
- Depressed skull fracture
- Occipital head strike with cerebellar contusion and sinus thrombosis
- Depressed skull fracture
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carpal bones
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hip
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femoral neck fracture
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