Skull Fractures: Part I

The skull is divided into two main parts:

• Neurocranium: formed by cranial bones that house and protect the brain. This is sometimes called the “braincase.”
• Viscerocranium: bones that form and protect the face.

The number of bones that form each the two parts can differ based on the authorities consulted. For example, some authorities count bones that are paired as separate bones and some count them as one. One classification of the bones of the skull could result in 22 bones. Eight of them are in the neurocranium:

• The occipital bone
• Two temporal bones
• Two parietal bones
• One sphenoid bone: a single, irregular, wedge-shaped bone at the base of the skull, forming part of the floor of the anterior, middle and posterior cranial fossae
• One ethmoid bone: located between the orbits of the eyes
• One frontal bone

Not surprisingly, this formation largely corresponds with the main exterior lobes of the brain and provides protection for them.

Correspondingly, and by the same classification, the viscerocranium contains 14 bones:

• One vomer: a flat trapezoidal bone forming the inferior and posterior portion of the nasal septum
• Two conchae: several types are located in several parts of the face and head
• Two nasal bones
• Two maxilla
• One mandible
• Two palatine bones: fused together to form the palatine. It is located in the back part of the nasal cavity and protects organs there, the roof of the mouth and the eye socket.
• Two zygomatic bones: the cheek bones
• Two lacrimal bones: the smallest and most fragile bones of the face, located at the front part of the medial (inside) side of the orbit of the eye.

A skull fracture is, as the term suggests, a break in one or more of the bones that comprise the cranial portion of the skull. It usually results from blunt force trauma and, depending upon the force of the trauma, the bone may fracture at or near the site of the impact. Although the skull is designed to, and works quite well in protecting the brain from injury, the protection is not complete under all circumstances. A fracture may result in trauma to the underlying physical structures within the skull. These structures include membranes, blood vessels and most significantly, the brain itself.

A particularly dangerous consequence of a skull fracture is an increase in intracranial pressure that results in brain herniation. The herniation can cause the brain to extrude out of the foramen magnum because there is no other space for the brain to expand. The foramen magnum is a large opening at the base of the skull through which the spinal cord passes. Brain damage or death can occur if this is not surgically treated quickly, and is one of the reasons why individuals who sustained concussions must be monitored closely and carefully.

While an uncomplicated skull fracture can be without clinical significance and not carry with it significant risk of physical or neurological injury, other traumatic injuries to the brain due a skull fracture can be life-threatening, catastrophic injuries. Short of death, the injury can require a course of rehabilitation. Early intervention is of utmost importance.

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.

We focus on the achievement of personal fulfillment, increased independence and successful outcomes to the greatest degree possible.

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Mount Dora, Florida 32757