Treatment for Skull Fracture (Child)

Outline of boy's head in profile showing brain in cross section.

A skull fracture is a type of head injury. It is a break in the skull bone. Fractures range from mild to severe and can have different symptoms. Some fractures are just a hairline. Others are more serious with bone fragments lodged in the brain, or a blood clot pushing on the brain.

Types of treatment

Treatment depends on how severe the injury is. Treatment for a mild injury may include:

  • Icing the injured area

  • Rest

  • Watching your child over time for other symptoms

  • Pain medicine

A cut from the injury may be treated with antibiotic ointment and a bandage. A large cut may be closed with staples or stitches. If the cut is deep, your child might need antibiotics, especially if the cut goes down to the fracture.

A more serious injury may mean your child may need treatment right away. Or your child may need to stay in the hospital to be watched. In some cases, a child may need:

  • Medicine to help them relax and sleep

  • To be closely watched in the intensive care unit

  • Help with breathing by using a breathing machine (mechanical ventilator)

  • Tests to find out how serious the injury is, such as a CT, MRI, or an EEG.

  • Surgery

Your child may need to see a traumatic brain injury specialist. This type of healthcare provider can watch for and treat postconcussive syndrome. This is a complex series of symptoms that can occur after a head injury.

Watching intracranial pressure (ICP)

Head injury may cause the brain to swell. Because the brain is covered by the skull, there is only a small amount of room for it to swell. This causes pressure inside the skull to increase. The pressure inside the skull is known as intracranial pressure (ICP). Too much ICP can lead to brain damage.

Your child’s ICP may need to be measured in the hospital. ICP can be measured with 2 small devices:

  • An external ventricular drain. This is a small hollow tube (catheter) placed into the fluid-filled space in the brain (the cerebral ventricles).

  • A small wire device placed through a bolt fixed to the skull into the space just between the skull and the brain, or directly in the brain.

One or both of these devices may be put in place by the healthcare provider in the hospital. It is then attached to a monitor. This gives a constant reading of the pressure inside the skull. If the pressure goes up, it can be treated right away.

While the ICP device is in place, your child will be given medicine to prevent pain. The device will be removed when it is no longer needed.

Living with brain injury

In some cases, a child who has a severe brain injury may lose some muscle function (paralysis), speech (aphasia), vision, hearing, or taste. This depends on the area of the brain that is damaged. A child may also have changes in personality or behavior. These changes may get better, or they may last for a long time. Brain injury symptoms may need lifelong treatment. Treatment may include medicine. It may also include physical, occupational, or speech therapy.

You can also help your child by focusing on their abilities at home and in the community. Be positive about their skills. This will help your child to have self-esteem and independence. Work with your child’s healthcare provider.

Preventing skull fracture

You can help create a safe playing environment for your child. This can help to prevent a head injury. Make sure to have your child:

  • Wear a seatbelt in the car or any other vehicle

  • Wear a helmet for activities, such as bike riding, skating, and skateboarding

  • Wear a helmet whenever they are outside, if your child has severe epilepsy or other diseases that put them at high risk of falling

When to call your child’s healthcare provider

Call the healthcare provider if your child has:

  • Upset stomach (nausea)

  • A headache that won’t go away

Call 911

Call 911 if your child has any of these:

  • Vomiting

  • A severe headache

  • Trouble walking

  • Eyesight or hearing problems

  • Weakness or numbness

  • Is acting different from normal

  • Has blood or fluid leaking from the nose or ear

  • Loses consciousness