Depressed skull fracture
Citation, DOI, disclosures and article data
Citation:
Bickle I, Sharma R, Abu Jebbeh F, et al. Depressed skull fracture. Reference article, Radiopaedia.org (Accessed on 10 Mar 2025) https://doi.org/10.53347/rID-29691
Permalink:
rID:
29691
Article created:
Disclosures:
At the time the article was created Ian Bickle had no recorded disclosures.
View Ian Bickle's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures
Revisions:
13 times, by
9 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Depressed skull fractures
Depressed skull fractures result in the bone of the skull vault being folded (depressed) inward into the cerebral parenchyma. It is usually the result of a high energy impact to the skull.
On this page:
Pathology
These mostly (~75%) occur in the frontoparietal region 3.
Associations
There are a number of associated injuries with depressed skull fractures 1,2:
- extradural hematoma
- subdural hematoma
- cerebral contusion
- subarachnoid hemorrhage
- pneumocephalus
- CSF leak
Radiographic features
Plain radiograph
Rarely undertaken, especially outside of the pediatric population. The fracture is identified due to the projection of dense bone over the skull.
CT
The modality of choice in head trauma. The fracture is shown in detail along with any associated injuries.
Treatment and prognosis
There are a number of indications for operative management, these include 2-4:
- dural breach, increased risk if >5 mm depression from inner table
- depression >5-10 mm
- significant intracranial hemorrhage
- frontal sinus involvement
- significant wound contamination or cosmetic deformity
- pneumocephalus
Depressed skull fracture are associated with higher rates of infection (~10%), seizure (~15%), neurological deficits, and death 3.
References
- 1. Brant WE, Helms CA. Fundamentals of Diagnostic Radiology. Lippincott Williams & Wilkins. (2007) ISBN:0781761352. Read it at Google Books - Find it at Amazon
- 2. Pope TL. Harris & Harris' Radiology of Emergency Medicine. Lippincott Williams & Wilkins. (2012) ISBN:145110720X. Read it at Google Books - Find it at Amazon
- 3. The Neurosurgeon's Handbook. Oxford University Press. ISBN:0198570678. Read it at Google Books - Find it at Amazon
- 4. Kaye. Essential Neurosurgery. John Wiley & Sons. (2009) ISBN:1405148179. Read it at Google Books - Find it at Amazon
Incoming Links
Articles:
Cases:
- Cervicomedullary junction contusion
- Depressed skull fracture
- Ping pong skull fracture
- Multifocal orbital and calvarial fractures
- Orbital roof blow-in fracture
- Skull fracture
- Epidural hematoma with depressed skull fracture
- Traumatic brain injury with depressed skull fracture
- Depressed skull fracture
- Depressed skull fracture with extradural haematoma
- Penetrating head injury
- Paediatric ceiling fan-induced head injury
- Depressed frontal fracture
- Intraparenchymal haemorrhage and pneumocephalus
- Extradural haemorrhage
- Traumatic brain injuries
- Depressed fracture of the frontal sinuses due to head butt
- Depressed skull fracture
- Occipital head strike with cerebellar contusion and sinus thrombosis
- Depressed skull fracture
Related articles: Fractures
-
fracture
- terminology[+][+]
- fracture location
- diaphyseal fracture
- metaphyseal fracture
- physeal fracture
- epiphyseal fracture
- fracture types
- avulsion fracture
- articular surface injuries
- complete fracture
- incomplete fracture
- infraction
- compound fracture
- pathological fracture
- stress fracture
- fracture displacement
- fracture location
- fracture healing[+][+]
-
skull fractures
- base of skull fractures[+][+]
- skull vault fractures
- depressed skull fracture
- ping pong skull fracture
-
facial fractures[+][+]
- fractures involving a single facial buttress
- alveolar process fractures
- frontal sinus fracture
- isolated zygomatic arch fractures
- mandibular fracture
- nasal bone fracture
- orbital blow-out fracture
- paranasal sinus fractures
- complex fractures
- dental fractures
- fractures involving a single facial buttress
-
spinal fractures[+][+]
- classification (AO Spine classification systems)
-
cervical spine fracture classification systems
- AO classification of upper cervical injuries
- AO classification of subaxial injuries
- Anderson and D'Alonzo classification (odontoid fracture)
- Roy-Camille classification (odontoid process fracture)
- Gehweiler classifcation (atlas fractures)
- Levine and Edwards classification (hangman fracture)
- Allen and Ferguson classification (subaxial spine injuries)
- subaxial cervical spine injury classification (SLIC)
- thoracolumbar spinal fracture classification systems
- three column concept of spinal fractures (Denis classification)
- classification of sacral fractures
-
cervical spine fracture classification systems
- spinal fractures by region
- spinal fracture types
- classification (AO Spine classification systems)
- rib fractures[+][+]
- sternal fractures
-
upper limb fractures[+][+]
- classification
- Rockwood classification (acromioclavicular joint injury)
- AO classification (clavicle fracture)
- Neer classification (clavicle fracture)
- Neer classification (proximal humeral fracture)
- AO classification (proximal humeral fracture)
- AO/OTA classification of distal humeral fractures
- Milch classification (lateral humeral condyle fracture)
- Weiss classification (lateral humeral condyle fracture)
- Bado classification of Monteggia fracture-dislocations (radius-ulna)
- Mason classification (radial head fracture)
- Frykman classification (distal radial fracture)
- Mayo classification (scaphoid fracture)
- Hintermann classification (gamekeeper's thumb)
- Eaton classification (volar plate avulsion injury)
- Keifhaber-Stern classification (volar plate avulsion injury)
- upper limb fractures by region
- shoulder
- clavicular fracture
-
scapular fracture
- acromion fracture
- coracoid process fracture
- glenoid fracture
- humeral head fracture
- proximal humeral fracture
- humeral neck fracture
- arm
- elbow
- forearm
- wrist
-
carpal bones
- scaphoid fracture
- lunate fracture
- capitate fracture
- triquetral fracture
- pisiform fracture
- hamate fracture
- trapezoid fracture
- trapezium fracture
- hand
- shoulder
- classification
- lower limb fractures[+][+]
- classification by region
- pelvic fractures
- hip fractures
- Pipkin classification (femoral head fracture)
- Garden classification (hip fracture)
- American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture)
- Cooke and Newman classification (periprosthetic hip fracture)
- Johansson classification (periprosthetic hip fracture)
- Vancouver classification (periprosthetic hip fracture)
- femoral
- knee
- Schatzker classification (tibial plateau fracture)
- AO classification of distal femur fractures
- Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture)
- tibia/fibula
- Watson-Jones classification (tibial tuberosity avulsion fracture)
- ankle
- foot
- Berndt and Harty classification (osteochondral lesions of the talus)
- Sanders CT classification (calcaneal fracture)
- Hawkins classification (talar neck fracture)
- Myerson classification (Lisfranc injury)
- Nunley-Vertullo classification (Lisfranc injury)
- pelvis and lower limb fractures by region
- pelvic fracture
- sacral fracture
- coccygeal fracture
-
hip
- acetabular fracture
- femoral head fracture
-
femoral neck fracture
- subcapital fracture
- transcervical fracture
- basicervical fracture
-
trochanteric fracture
- pertrochanteric fracture
- intertrochanteric fracture
- subtrochanteric fracture
- femur
- mid-shaft fracture
- bisphosphonate-related fracture
- distal femoral fracture
- knee
- avulsion fractures
- Segond fracture
- reverse Segond fracture
- anterior cruciate ligament avulsion fracture
- posterior cruciate ligament avulsion fracture
- arcuate complex avulsion fracture (arcuate sign)
- biceps femoris avulsion fracture
- iliotibial band avulsion fracture
- semimembranosus tendon avulsion fracture
- Stieda fracture (MCL avulsion fracture)
- patellar fracture
- tibial plateau fracture
- avulsion fractures
- leg
- tibial tuberosity avulsion fracture
- tibial shaft fracture
- fibular shaft fracture
- Maisonneuve fracture
- ankle
- foot
- tarsal bones
- metatarsal bones
- phalanges
- classification by region
- terminology[+][+]
Unable to process the form. Check for errors and try again.
