bones or a separation of the sutures.
(1) Basilar skull fractures are potentially serious injuries due to the proximity
of the brain stem.
(2) Depressed skull fractures may be open or closed. In either case, the
underlying brain tissue may be damaged.
(3) Linear skull fractures are "cracks." They may be dangerous if they
overlie vascular structures.
d. Hematomas. Hematomas are a result of bleeding within the closed
compartment of the skull. They may cause compression of brain tissue.
Epidural hematoma is caused by bleeding between the skull and the
(2) Subdural hematoma is caused by bleeding between the dura and the
(3) Subarachnoid hemorrhage/hematoma is caused by bleeding into the
e. Concussion. Concussion results from violent jarring of the brain against the
interior of the skull. The patient experiences a brief loss of consciousness followed by
confusion, headache, and irritability. Complete recovery is usual.
f. Contusion. This injury is more serious than a concussion. The severe
jarring of the brain causes bruising of the brain. (This bruising is the result of blood
vessel rupture.) Permanent damage may result.
2-40. INCREASED INTRACRANIAL PRESSURE
a. Definition. The cranium is a closed cavity filled with contents that are
virtually noncompressible. Rapid or prolonged increases in an intracranial pressure
present a serious threat to life. This increased pressure may result from edema,
bleeding, trauma, or space-occupying lesions. Once the pressure exceeds the
accommodation point, the brain will herniate through weak points (for example, the
foramen magnum). Irreversible neurological damage or death will result.
b. Signs and Symptoms of Increased Intracranial Pressure.
Change in level of consciousness.
May occur over a period of minutes, hours, or days.