Skull and facial fractures are broken bones of the head and face. Injury can result in damage to the brain.
Types of skull fractures include:
Facial fractures can occur in any of the face’s bones. They are named for specific areas of the face:
Fractures may either be:
Both skull and facial fractures may be life-threatening conditions. They require immediate medical treatment.
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Skull and/or facial fractures are caused by direct trauma to the head. Trauma can be caused by:
Factors that may increase the chance of a skull and/or facial fracture include:
Specific factors that may also increase a child's risk of a skull fracture include:
These will depend on the location, type, and extent of the injury.
A skull or facial fracture may cause:
Some trauma causes bleeding in the brain. A hematoma occurs when a pocket of blood leaks into the spaces between the brain and the skull, increasing intracranial pressure. Signs of injury to the brain or hematoma include:
Concussion may cause:
You will most likely be taken to a hospital. A doctor will ask about your symptoms and how your injury occurred. A physical exam will be done. A neurological exam will evaluate your nervous system. Tests may include the following:
If you are in a situation where there is a skull or facial fracture injury, call for medical help right away.
Treatment will depend on the location and extent of the injury.
The first steps will be focused on stabilizing the injury. They may include:
Stabilization may also require emergency surgery to protect surrounding tissues and organs.
Some fractures cause pieces of bone to separate. The doctor will need to put these pieces back into their proper place. This may be done:
Nearly half of skull and facial fractures require surgical repair. Surgery may not be done until the fracture is stabilized and swelling at the injury site goes down.
People with these fractures usually need to stay in the hospital. Serious injuries may need to be watched in an intensive care unit. Some people with skull or facial fractures need to have help breathing. A tube is inserted and mechanical ventilation is used to protect and assist breathing.
The following medications may be prescribed:
Healing time varies by age and overall health. Children and people in better overall health heal faster. In general, it may take several weeks for a skull or facial fracture to heal.
Activities will need to be adjusted, but complete rest is rarely required. Ice may also be recommended to help with discomfort and swelling.
Physical therapy or rehabilitation may be needed to keep muscles strong.
To help reduce your chance of a skull and/or facial fracture:
To help reduce falling hazards at work and home:
American College of Emergency Physicians.
Brain Injury Association of America
The Brain Injury Association of Canada
Canadian Association of Emergency Physicians
Concussion and mild traumatic brain injury. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116529/Concussion-and-mild-traumatic-brain-injury. Updated June 21, 2017. September 1, 2017.
Facial fractures. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/head-neck/treatments-services/facial-fractures. Updated November 12, 2015. Accessed September 1, 2017.
Maxillofacial injuries. Patient UK website. Available at: http://patient.info/doctor/maxillofacial-injuries. Updated December 19, 2014. Accessed September 1, 2017.
Moderate to severe traumatic brain injury. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900588/Moderate-to-severe-traumatic-brain-injury. Updated April 10, 2017. Accessed September 1, 2017.
NINDS traumatic brain injury information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Traumatic-Brain-Injury-Information-Page. Accessed September 1, 2017.
Park CH, Lee JH, Hong SM, Lee OJ. Reduction of inferior orbital wall fractures using a Foley catheter and an endoloop. J Trauma. 2011;70(3):E38-E41.
Skull fracture—emergency management. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T902792/Skull-fracture-emergency-management. Accessed September 1, 2017.
Subdural hematoma. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114154/Subdural-hematoma. Updated March 16, 2017. Accessed September 1, 2017.
Traumatic brain injury and concussion. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/TraumaticBrainInjury/index.html. Updated July 6, 2017. Accessed September 1, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 9/30/2013