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Step 1
Obtain a patient history. Most linear skull fractures do not produce systemic symptoms. Some swelling at the site of impact may be present and the skin may be breached.
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Step 2
Examine the patient for more serious symptoms of a skull fracture. These include bleeding from the wound, ears or nose, headaches and tenderness at the site of impact.
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Step 3
Look for signs of neurological deficit, including blurred vision, confusion, loss of balance or consciousness, convulsions, drowsiness, irritability, nausea, changes in pupil size, slurred speech, stiffness in the neck and vomiting.
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Step 4
Perform Computed Tomography (CT) scans as an essential imaging technique for detecting skull fractures. Plain radiographs are contraindicated if a skull fracture is suspected. They detect 5 percent of skull fractures and only delay a CT-based diagnosis.
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Step 5
Use CT images with wide windows to prevent linear or slightly depressed fractures from being overlooked. Skull sutures are symmetrical and have corticated margins, unlike fractures. A small streak on the image may indicate a misaligned fracture. The presence of air in the skull on a CT image may indicate a basilar fracture.
