Skull Fractures
One of the most common accidents concerning the pediatric age group is a fall. In this connection, we,
the pediatricians , always get calls from mothers telling us that their infants and/or toddlers fell from the bed.
And the questions that we ask during the history taking are the following: * What time did the accident happen?
– Where did the accident happen?
– How did the accident happen?
– How high was the fall?
– Is the floor made of wood? Or tiles? Or is there a carpet or mat on the floor?
– Did the child cry right after the fall?
– Did the child lose consciousness after the fall?
– Did the child vomit right after the accident? And if he did vomit, how many
hours from the accident?
There could be linear fracture of the skull or depress fracture of the skull during fall.
When you say linear fracture in infants, it will generally heal in about 3-4 months. If clinically, the child with a linear fracture is stable with no episodes of recurrent vomiting, is playful and active, then the parents are advised to continue their close
monitoring and to come back immediately if otherwise.Children with depressed fractures of the skull need interventions and they are referred
to neurologists and neuro surgeons for further management.
Basal skull fractures are rare but highly possible
when there is cerebrospinal fluid oto or rhinorrhea or if there is postauricular ecchymosis.
Also, children with fractures should be watched for complications particularly a leptomeningeal
cyst which happens when injury occurs before 3-4 years of age.
Injuries to the cranial nerves are also common in basal skull fractures especially injury to the
olfactory nerve. Injury to the olfactory nerve is permanent thus the sense of smell is affected. Likewise, injury to the auditory nerve may be temporary or permanent.
Injury to the facial
nerve may recover spontaneously.