The skull is a closed box made of many bones that are united by immovable joints. It protects the It can be fractured by a direct blow or falling on the head from a height. It can also be fractured by indirect e.g. falling from a height, landing on the feet. Direct trauma usually fractures the vault of the skull, while indirect trauma fractures the base of the skull and injury to the vertebral column. Fracture of the skull is a very serious injury, because it may be associated brain damage. The brain can be bruised. Or there may be bleeding outside the brain, and the hematoma compresses the brain. The fracture may be linear, depressed, comminuted.
The condition is diagnosed by the following features.
- There is often a wound on the scalp in case of direct trauma to the head.
- Cerebrospinal fluid may be found leaking from the ear or nose, as clear fluid or watery blood.
- Unconsciousness that lasts for more than three minutes is suggestive of a fracture of the skull
- There is a soft, boggy area depression under the scalp at the site of the fracture.
- Features of brain injury are seen, e.g. paralysis, altered sensorium, irritability and convulsions.
- If the victim is unconscious, place him in the recovery position.
- If there is cardiorespiratory arrest, resuscitate him.
- Do not move him unnecessarily.
- Control any bleeding from the scalp. Look for, and treat, other injuries.
- Send him to a hospital immediately.