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An infant skull fracture that occurs during delivery has the potential to damage the sensitive young brain and cause injuries ranging from mild to severe.  These injuries could be temporary, but may also cause permanent disabilities. It is not always immediately obvious if a child has been born with a skull fracture, but there are some signs and diagnostic techniques that can indicate such an injury.
The good news for parents and their babies is that most of these skull fractures come with a good prognosis. Most are mild and do not cause lasting injuries. On the other hand, the few cases that do cause lasting damage can be very serious. The prognosis for these more severe fractures may range from mild, long-term complications to severe and permanent physical and mental disabilities.
What Are Infant Skull Fractures?
A skull fracture is any break in the skull, which can occur during childbirth. The newborn skull is not fully formed and is, therefore, more susceptible to injury than the skull in a child or adult. This young skull is made of plates that are loosely held together by sutures. This gives it the flexibility to come through the narrow space of the birth canal.
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In spite of this flexibility, the newborn skull still may be fractured in a number of ways. A linear fracture is a simple break that does not allow the bone to move up or down or side to side. A depressed skull fracture occurs when the break causes the skull to sink down. 
These fractures are easier to see as soon as a baby is born. A diastatic fracture occurs along a suture. These have the potential to be serious because they are not easy to detect and they are likely to grow larger as the baby’s brain grows, causing damage to the brain.
What Causes Infant Skull Fractures?
In very rare cases an infant’s skull may fracture spontaneously, or with no recognizable cause, during childbirth. More commonly these injuries are caused by the inappropriate use of instruments like forceps and vacuum extractors.
These instruments are more commonly used during difficult labors or those with complications, like a breech position. For this reason, a difficult or complicated labor is a risk factor for infant skull fractures.
The instruments that most often cause infant skull fractures do so when the doctor uses them with too much force. Squeezing the baby’s head with forceps or using the vacuum extractor in the wrong way can both cause breaks in the skull. A doctor not ordering a Cesarean section when there are complications can be considered malpractice if the baby becomes injured as a result.
What Is the Infant Skull Fracture Prognosis?
For most infants suffering a skull fracture caused by labor and delivery, the prognosis will be positive. In most cases, there is no lasting or long-term injuries or complications. The skull will likely heal on its own and cause no further problems. In some cases, even if there is damage that requires treatment, that treatment will help the skull and brain heal.
In other instances, the skull fracture may cause more serious complications and the prognosis for the baby is not as positive. A child with a skull fracture that occurred during birth could end up with a brain injury, a growing skull fracture, a hemorrhage or bleeding on the brain, increased pressure on the brain, or a long-term disability that includes neurological damage, developmental delays, cognitive impairment, or paralysis.
Grow Skull Fracture
One potential complication of a birth injury skull fracture is the development of a growing skull fracture, or a growing skull fracture often referred to as GSF. This is a rare complication. The fracture continues to grow over time as the growth of the brain puts pressure on it. 
A GSF most often occurs when the skull fracture is not diagnosed right away. It may take several months to recognize symptoms and get a diagnosis.
A GSF can be treated, and most often must be treated, usually with surgery. The earlier this complication is recognized and treated, the better the outlook is for the child. This type of growing fracture is life-threatening. If it is not found and treated, a baby could suffer serious brain damage, have seizures, go into a coma, and ultimately die.
When an infant skull fracture case includes a brain hemorrhage, it means that there is bleeding in the brain. This most often occurs when the fracture is a depressed fracture. On other words, the skull has actually sunken down towards the brain. The resulting hemorrhage can cut off oxygen to parts of the brain or put pressure on the area of the brain affected. 
The prognosis for most cases of a skull fracture causing bleeding are good. Swift treatment, which involves draining the blood to relieve pressure, is usually enough to ensure there is no lasting damage. However, if the bleeding is severe, if it is not treated right away, or if it is not diagnosed soon enough, the prognosis may be lasting brain damage.
Long Term Disability
In rare, but serious cases, the infant skull fracture prognosis is a permanent disability. When the fracture causes serious injury to the brain or the fracture goes unnoticed and the damage untreated for too long, the result can be serious brain damage. This may result in cognitive impairments, developmental delays, paralysis, nerve damage, and other consequences.
Lasting damage from an infant skull fracture is a terrible prognosis for any parent to receive. To know your child will always live with the complications from this injury is devastating. You may want to get justice and seek compensation for your child by filing a lawsuit over medical malpractice.
If you do, make sure you work with a lawyer experienced in birth injury cases to give you and your child the best chance of getting the money you need to cope with infant skull fracture complications.
An infant brain damage prognosis depends on individual factors: the severity of the damage, when it’s diagnosed, how it is treated, and more. Luckily, most cases of infant brain damage incurred during childbirth are mild and the prognosis is good.
For infants that suffer moderate to severe damage, the prognosis is less positive. These children may be living with the complications of brain damage indefinitely, and in some cases, it can be fatal.
- Pediatric Skull Fractures - StatPearls - NCBI Bookshelf. (2019, May 2). National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK482218/
- Head Injury in Children. (n.d.). Johns Hopkins Medicine, based in Baltimore, Maryland.
Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/head-injury-in-children
- Liu XS , et al. (n.d.). Growing skull fracture stages and treatment strategy. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/22656261
- Intraventricular hemorrhage of the newborn : MedlinePlus Medical Encyclopedia. (n.d.). MedlinePlus - Health Information from the National Library of Medicine.
Retrieved from: https://medlineplus.gov/ency/article/007301.htm