Open Head Injuries
There are several types of skull fractures that can occur with open head injuries:
- Depressed Skull Fracture occurs when the broken piece of skull bone moves in towards the brain.
- Compound Skull Fracture occurs when there is a cut on the scalp and the skull is fractured.
- Basilar Skull Fracture occurs when the skull fracture is located at the base of the skull (neck area) and may include the opening at the base of the skull. These specific fractures can cause damage to the nerves and blood vessels that pass through the opening at the base of the skull.
- Battle’s Sign fracture occurs when the fracture is located at the ear’s petrous bone.This produces large “black and blue mark” looking areas below the ear, on the jaw and neck and it may include damage to the nerve for hearing. Blood or cerebral spinal fluid may also leak out of the ear. This is termed “CSF Oterrhea.”
- Racoon Eyes occurs when the skull fracture is located in the anterior cranial fossa, whichThis produces “black and blue” or bruised areas around the eyes. Cerebral spinal fluid may leak into the sinuses. This is termed “CSF Rhinorrhea”. Nerve damage to the nerves that control the sense of smell or eye functions may occur.
- Diastatic Skull Fracture The skulls of infants and children are not completely solid until they grow older. The skull is composed of jigsaw-like segments (cranial fissures) which are connected together by cranial sutures. Skull fractures that separate the cranial sutures in children prior to the closing of the cranial fissures are termed “diastatic skull fractures.”
- Cribiform Plate Fracture The cribiform plate is a thin structure located behind the nose area. If the cribiform plate is fractured, cerebral spinal fluid can leak from the brain area out the nose.
Closed Head Injuries
When there is a blow to the head which causes a head injury and the skull does not fracture, it is referred to as a “closed head injury.” When there is a closed head injury, the brain swells and has no place to expand. This leads to an increase in intracranial pressure and causes tissues to compress, causing further injury. As the brain swells, it may expand into different areas of the skull, including the eye sockets, which can affect normal vision.