One page summary: Skull fracture in newborns

In two sentences

A newborn skull fracture is a break or a dent in one of the skull bones. Most are linear cracks that heal on their own without treatment. ¹

The concern with a skull fracture is rarely the bone. It is what may be underneath: bleeding between the skull and the brain, or injury to the brain itself. That is why imaging looks at the brain and not only at the bone. ¹

The numbers, with their sources

• The common type. A linear fracture, a simple crack with no displacement, which typically heals without treatment ¹
• The type that may need a procedure. A depressed fracture, where a section of bone is pushed inward, sometimes described as a ping-pong ball dent in a newborn ¹
• What matters most. Whether there is bleeding under the fracture. Epidural hematoma in newborns is usually associated with a skull fracture ¹
• The main associations. Instrument-assisted birth, particularly forceps, and difficult deliveries ²
• Imaging. CT is fast and shows both bone and fresh bleeding. MRI shows brain detail without radiation ¹
• A rare late complication. A growing skull fracture, where a fracture widens over months because the underlying membrane was torn, which is why follow-up is arranged ¹

What to do this week

1. Ask whether there is any bleeding under the fracture, and what imaging showed.
2. Ask whether it is linear or depressed, and what the plan is for each.
3. Ask what neurological signs they are watching for and what should make you call.
4. Ask whether bilirubin is being followed.
5. Ask whether repeat imaging is planned and why or why not.
6. If an instrument was used, ask which, how many attempts, and whether the cup detached. Request the operative note.
7. Ask about a soft pulsating swelling appearing later, so you know what to report.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the neonatologist or neurosurgeon

• Is this linear or depressed, and how deep?
• Is there any bleeding underneath?
• Does this need a procedure, or will it lift on its own?
• What neurological signs are you watching for?
• Is follow-up imaging planned?

For the obstetric team

• Was an instrument used, and which one?
• How many attempts, and were both vacuum and forceps used?
• What was the indication?
• Is it all in the operative note?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Skull fracture in newborns

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.