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Infant skull fracture symptoms may range from mild and not even noticeable to severe and debilitating. An infant may suffer such a fracture for a variety of reasons, but the most common cause is the use of instruments during childbirth.
Forceps, for instance, may be used by the doctor to grasp a baby’s head during delivery and this force can lead to a fracture and even subsequent brain damage and lasting disabilities and symptoms.
Noting the signs and symptoms of an infant skull fracture is important because the consequences of not treating this injury can be serious. Both parents and the medical team need to be aware that a fracture may have occurred, look for the signs, and take any necessary steps to confirm a skull fracture diagnosis and to use appropriate treatments to prevent or correct any brain damage or physical damage.
How Infant Skull Fractures Occur
Infant skulls are flexible and made up of plates that are attached by soft tissue called sutures. These harden eventually but allow the brain to grow into an expanding skull and allow the skull to survive the pressures of the womb and childbirth. The latter does not always happen, and even without any kind of doctor error, an infant’s skull can fracture during delivery, simply due to the pressure. 
More often, though, the cause of an infant’s skull fracture can be due to medical malpractice. The number one cause of an infant skull fracture during delivery is from the force of instruments, typically forceps or a vacuum extractor. These instruments can help deliver a baby quickly if there are complications, but they can also fracture the skull.
A medical error may also be involved when the infant’s skull is fractured during natural delivery with no instrument use. If the child is unusually large or presents in the breech position or if the delivery is long and difficult, the baby may be at a greater risk of suffering a fracture. If the doctor failed to recognize there would be these complications and did not perform a Cesarean section, the result may be a fracture.
Types of Skull Fractures
The symptoms of an infant skull fracture depend on factors such as the severity of the fracture, but also on the type.  A linear fracture is a simple line fracture that is most often the least complicated and causes the fewest and mildest symptoms. The fracture does not cause the plates of the skull to move and often this type of fracture heals without any intervention.
Depressed skull fractures are much more likely to cause symptoms and to have serious complications. This kind of fracture is easy to spot and occurs when the skull is sunken down toward the brain. It should be readily visible.
Diastatic skull fractures are fractures along a suture. Like a linear fracture, these may not cause symptoms right away, but they may be more serious. As the child’s brain grows the fracture may grow as well and cause problems.
Signs of Mild Fractures
Mild infant skull fracture symptoms may be nonexistent. Some signs may include irritability, sensitivity to light and sounds, abnormal eye movement, seizures, lethargy, listlessness, crying, difficulty sleeping, and difficulty in nursing.
Fortunately for most mild fractures, there are no lasting consequences or symptoms. Sometimes the immediate signs are so insignificant that the fracture is not detected.
Signs of Moderate to Severe Skull Fractures
Physical signs of a more severe skull fracture in a newborn may include swelling, a lump, or a depression on the head. There may be bruising around the eyes or fluid or blood coming out of the baby’s ears or nose.
A more serious skull fracture may cause brain damage or a traumatic brain injury. Signs include difficulty in nursing, crying for no apparent reason and being difficult to console, listlessness and lethargy, unexplained irritability, and difficulty focusing on anything. Seizures may also be a sign of brain damage associated with a skull fracture.
If a skull fracture is suspected because of some of these signs, doctors may use imaging scans, like a CT scan or MRI to confirm the fracture’s location and the extent and to find out if it has caused a hematoma or bleeding on the brain. 
A hematoma may be associated with symptoms like irritability, seizures, crying, and difficulty sleeping or nursing. Bleeding on the brain can put damaging pressure on it and depending on the severity, may or may not need to be drained surgically. In severe cases, this bleeding may cause lasting brain damage or even death.
Long-Term Brain Damage
Over the long-term, skull fracture may cause a wide variety of symptoms depending on the severity of the brain damage and how it was treated after the skull fracture was discovered. These long-term symptoms may include cognitive, developmental, perceptual, physical, and behavioral complications.
Cognitive symptoms may include memory problems, a lower than average IQ, difficulty paying attention or focusing, a short attention span, learning disabilities, difficulty understanding the abstract, and difficulty making decisions. Perceptual symptoms include impaired vision and hearing, trouble with balance or coordination, sensitivity to pain, and spatial disorientation. 
Physical signs of brain damage include seizure disorders, fatigue, headaches, difficulty speaking, difficulty sleeping, loss of consciousness, tremors, and paralysis varying from partial and mild to severe. Children with brain damage may also have behavioral and emotional challenges that include impatience, difficulty coping with stress, irritability, either heightened or flattened emotions, aggression and lethargy.
Infant skull fracture symptoms are varied, ranging from immediate and either mild or severe to long-lasting. If you suspect your child was injured during childbirth, don’t hesitate to ask your doctor about imaging to check for a fracture.
Any sign of a fracture should be taken seriously as the consequences of ignoring it could be serious. If you think the fracture was caused by negligence, you may want to take steps to start a lawsuit to seek compensation for your child.
- Head Injury in Children. (n.d.). Johns Hopkins Medicine, based in Baltimore, Maryland.
Retrieved from: http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/head_injury_in_children_90,P02604/
- Pediatric Skull Fractures - StatPearls - NCBI Bookshelf. (2019, May 2). National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK482218/
- Harvard Health Publishing. (2019, September 24). Head Injury In Children. Harvard Health.
Retrieved from: https://www.health.harvard.edu/a_to_z/head-injury-in-children-a-to-z
- Pediatric Traumatic Brain Injury: Signs and Symptoms. (n.d.). American Speech-Language-Hearing Association | ASHA.
Retrieved from: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942939§ion=Signs_and_Symptoms