Fracture (cont.)

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Skull fracture

With the wide availability of CT scans, skull X-rays are rarely taken to diagnose head injury. If a head injury exists, the health care professional will feel or palpate the scalp and skull to determine if there may be a skull fracture present. A nervous system exam may be done assessing brain function. Fractures of the base of the skull may cause hemotympanum (blood behind the ear drum), Battle's sign (bruising behind the ear) ,or raccoon eyes (bruising surrounding the orbits of the eyes).

The skull is a flat, compact bone and it takes significant force to break it. If a skull fracture exists, there is an increased likelihood of bleeding in the brain, especially in children. There are guidelines that are available to decide whether a CT scan is indicated (needed).

Concussion describes a head injury, either a direct blow, or being  shaken or jarred where there is a temporary change in mental function, but the victim returns to normal status within 2 hours. With minor head injury, the following risk groups are considered when evaluating need for CT brain scan:

High risk for potential neurosurgical operation

  • Abnormal neurologic exam within two hours after injury
  • Suspected open or depressed skull fracture
  • Any sign of basal skull fracture (blood behind the ear drum, blackened eyes, clear fluid running from the ears, or bruising behind the ear)
  • Vomiting - two episodes
  • 65 years of age or older

Medium risk (for brain injury on CT)

  • Amnesia before impact - more than 30 minutes
  • Dangerous mechanism (pedestrian struck by motor vehicle, occupant ejected from motor vehicle, fall from height greater than three feet or five stairs)
Medically Reviewed by a Doctor on 4/9/2013

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Fracture - Describe Your Experience Question: Please describe what type of fracture you experienced.
Fracture - Causes Question: What caused your fracture?
Fracture - Treatment Question: Besides surgery, what types of treatment did you have for your bone fracture?
Bone Fracture - Signs and Symptoms Question: How did you know you had more than a sprain or strain? What were your signs and symptoms of a broken bone?
Bone Fracture - Surgery Question: Did you have surgery to fix your broken bone(s)? Which bone(s) did you fracture?