Elevation of Skull Fracture

Not all skull fracture will require treatment. The indications for treatment of skull fractures are:

  • Skull fragment indenting or penetrating the brain substance
  • Compound skull fractures requiring cleaning in the theatre
  • Markedly depressed skull fragment (depressed >100% the thickness of the skull)
  • Cosmesis

Operation

Surgery will involve elevation of the skull fragment and securing with either plates or rivets. In cases where the bone fragment is contaminated or markedly comminuted it may not be possible to use the bone fragments for fixation. A cranioplasty will then be performed using acrylic cement or titanium mesh.

Risks of this procedure

The risks of this operation includes the following. A detailed discussion with your surgeon is recommended prior to surgery.

  • Infection – superficial wound infection or deeper infections including meningitis, osteomyelitis
  • Bleeding – which may be superficial or deeper with reaccumulation of haematoma requiring a second operation
  • Seizures
  • Permanent neurological damage in the form of weakness, numbness, paralysis
  • Poor cosmetic result

Long term effects

If there is no associated head injury the patient can look to leave hospital in 1-2 days. The majority of skull fractures recover with no long-term effects. If there has been damage to the brain, some patients continue to have stroke-like symptoms like abnormal speech, weakness and numbness. Seizures may occur with scarring and disruption of the underlying brain tissue which is treated with medications.

For more information on St Vincent's Neuroscience services and additional resources visit our dedicated Neuroscience site here.