Depressed Skull Fracture

CT  Scan Bony Window is as shown below

There are two main classification of a depressed skull fracture and include:

1. Simple depressed fracture- no overlying laceration and no risk of infection
2. Compound depressed fracture- the risk here is the risk of a dural tear that may result in CSF leakage with meningitis/cerebral abscess

Be aware that if a patient is hypotensive, tachycardic suggest a ‘dural venous bleed’ that risk of haemorrhage can be catastrophic

Complications

1. Infection
2. Epilepsy

Management

Conservative or Surgical

Factors favouring surgical management

1. Neurological complications- focal deficit due to underlying cortical contusion
2. Open wound communicating with fracture
3. Away from dural venous sinus
4. dural laceration in a child
5. fracture depressed more than one table with of the skull
6. for cosmesis