Skull fracture injury

The brain is the most important part of the human body. Once damage occurs to the brain, it will have a huge impact on people and may even affect their lives. The brain can be said to be both fragile and hard. The fragility means that once the brain is damaged, the damage is irreversible and it is very difficult to recover. The hardness means that the brain tissue is surrounded by a thick skull. The skull plays a protective role for the internal brain tissues, so what should you do if you suffer a serious skull fracture?

Skull fractures are divided into skull cap and skull base fractures according to the fracture site; they are divided into linear fractures, depressed fractures, comminuted fractures, hole fractures and penetrating fractures according to the fracture morphology; and they are divided into open and closed fractures according to whether the fracture is connected to the outside world. Open fractures include skull base fractures with dura mater rupture and associated traumatic pneumocephalus or cerebrospinal fluid leak.

Skull fractures occur as a result of the reaction force generated by the violent action on the head. If the skull moves in the direction of the violent action and no reaction force is generated, fractures will not occur. Since the tensile strength of the skull is always lower than its compressive strength, when subjected to violence, the part that bears the tensile force will always break first. If the impact area is small, the skull will mainly be deformed locally; if the impact area is large, it may cause overall deformation of the skull, often accompanied by extensive brain damage.

Skull cap fracture is a fracture of the vault, and its incidence is most common in the parietal and frontal bones, followed by the occipital and temporal bones. There are three main types of skull fractures: linear fractures, comminuted fractures, and depressed fractures. The shape, location and direction of fracture are closely related to the direction, speed and point of force of violence. The fracture line of linear fracture often passes through the superior sagittal sinus, transverse sinus and meningeal vascular groove, which can cause intracranial hemorrhage. Depressed fractures are often caused by blunt force trauma with a small contact surface or by the head colliding with a protruding object. The entire layer of skull bone near the point of impact is often sunken into the skull, and there may be symptoms and signs of brain compression.

Skull base fractures are mainly linear and may be limited to a certain cranial fossa, or they may run horizontally through the skull base on both sides or vertically through the anterior, middle, and posterior cranial fossa. Since the fracture line often involves the paranasal sinuses, petrous bones or mastoid air cells, the cranial cavity and sinus cavity are connected to form an invisible open fracture, which can cause secondary intracranial infection.

A blow to the front of the forehead can easily cause anterior cranial fossa fracture, and the fracture line often passes through the sella turcica to the occipital bone; a blow to the anterior and lateral forehead can cause the fracture line to cross the midline through the cribriform plate or toward the sella turcica to the anterior cranial fossa or middle cranial fossa on the opposite side; a blow to the anterior part of the parietal area can cause a fracture line through the middle cranial fossa to the anterior cranial fossa on the opposite side; a blow to the posterior parietal area can cause the fracture line to pass through the middle cranial fossa to the anterior cranial fossa on the opposite side, and the fracture line points to the bottom of the middle cranial fossa and crosses the sella turcica or dorsum sella turcica inward to the opposite side; a blow to the occipital part can cause the fracture line to extend through the occipital bone to the petrous bone, or pass through the foramen magnum and bend to the petrous apex to the middle cranial fossa, or pass through the sella turcica to the anterior cranial fossa