Head Trauma: Concerns About Skull Indentation After Injury - Neurology

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Head trauma


Hello Doctor, two years ago at school, a classmate hit me hard on the right side of my head twice with a wooden broom, approximately near the frontal bone, causing the broom to crack.
At that moment, I only experienced bleeding and no other discomfort.
After returning home, I did not exhibit any symptoms of a concussion.
Recently, I noticed a depression or groove in the area where I was struck, which is not present on the other side of my skull.
I found information suggesting it could be a skull base fracture, and I am quite worried.
Could you please clarify this for me?

Kg, 10~19 year old female. Ask Date: 2023/09/08

Dr. Jiang Junyi reply Neurology


Hello Mr.
Kg: You mentioned that "there is a dented groove where I was hit, while the other side of the skull does not have this." After researching related information, it seems that this could be a skull base fracture.
However, the "skull base fracture" you are concerned about should have already healed.
The dented groove is likely a suture.
Generally, skull base fractures do not require special treatment; the focus is on monitoring for any brain injury and managing complications such as cerebrospinal fluid leaks and cranial nerve injuries.
The vast majority of leak sites will heal on their own within 1 to 2 weeks after the injury.
Thank you for your question, and feel free to discuss any related issues further! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Hospital, cares about you.

Reply Date: 2023/09/08

More Info


Head trauma can lead to a variety of symptoms and complications, and your concerns about the indentation in your skull following the injury are valid. When you experienced the impact from the wooden broomstick two years ago, it is possible that the force of the blow caused some structural changes to your skull, even if you did not experience immediate symptoms like a concussion.
The indentation you are feeling could be a result of localized bone remodeling or a depression fracture. In cases of trauma, the skull can sometimes absorb the impact by changing its shape, leading to a dent or depression in the bone. This is particularly true if the force was significant enough to cause a fracture, even if it was not severe enough to result in immediate neurological symptoms.
It's important to note that while many people recover from head injuries without long-term effects, some injuries can lead to complications that may not be immediately apparent. For instance, a skull fracture can sometimes lead to complications such as cerebrospinal fluid leaks or intracranial hemorrhages, which can develop over time. However, these complications typically present with symptoms like severe headaches, confusion, nausea, or changes in consciousness, which you have not reported.

Regarding your specific concerns about a possible skull base fracture, this type of fracture can occur with significant trauma and may lead to symptoms such as clear fluid leaking from the nose or ears, vision changes, or hearing loss. If you are not experiencing any of these symptoms, it is less likely that you have a skull base fracture, but it is still important to consult with a healthcare professional for a thorough evaluation.

In terms of the indentation itself, if it is not causing you any pain or discomfort and you are not experiencing any neurological symptoms, it may not require immediate intervention. However, if you notice any changes, such as increased pain, swelling, or new neurological symptoms, you should seek medical attention promptly. A healthcare provider may recommend imaging studies, such as a CT scan, to assess the integrity of the skull and rule out any underlying issues.

In summary, while the indentation in your skull is concerning, it is essential to consider the absence of acute symptoms and the time that has passed since the injury. If you have ongoing worries or if new symptoms arise, it would be prudent to consult a neurologist or a specialist in head trauma for a comprehensive assessment. They can provide you with the necessary guidance and reassurance regarding your condition. Remember, it is always better to err on the side of caution when it comes to head injuries.

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