The skull is the tough, bony framework of tightly connected bones, consisting of two parts, the cranium (the domed top, back, and sides which protect the brain) and the facial section which encases the sensory organs.
As with most broken bones, a skull fracture most often occurs as a result of a trauma, especially a car accident or a fall from a building or a hit to the head (usually due to cruelty/abuse). Unfortunately, if the protective skull has been fractured, there is the potential for brain injury to occur too. There are several types of break including:
Simple fracture – A break in the bone without damage to the skin or surrounding tissues.
Linear skull fracture – Break in the cranial bone that looks like a thin line. There is no movement or depression of the bone.
Depressed skull fracture – A break in the cranial bone with a depression inwards, towards the brain.
What are the symptoms of a fractured skull?
Symptoms depend on the severity of the injury and accompanying injuries to the brain or facial structures. Minor fractures may have few if any symptoms. Which is why it is so important to see your veterinarian if your cat has been involved in any kind of trauma, even if he seems well.
Bleeding and broken skin may or may not be present depending on the type of fracture.
Brain injuries usually present with neurological signs such as:
Ataxia (unsteady gait).
Unconsciousness or coma.
Changes in pupil sizes, either dilated (large) or constricted (small) or unequal (one large, one small).
Other injuries relate to the area affected
Difficulty eating (jaw).
Broken or missing teeth.
Unable to open or close the mouth (jaw).
Difficulty breathing (nose).
Facial swelling (cheek, nose, jaw).
How is a fractured skull diagnosed?
Your veterinarian will perform a physical examination and obtain a history from you.
X-rays of the skull will be taken to evaluate for skull, jaw and sinus injuries.
X-rays of the chest and abdomen to look for internal injuries.
MRI or CAT scans to check for brain injury, look for hematomas (a collection of blood outside the brain) and determine the extent of the bone fracture.
Neurological exam – Including checking the respiration, pupil size, eye movement and consciousness can help to determine the extent of brain injury.
How is a fractured skull treated?
Treatment depends on the severity of the injury. Stabilising and treating neurological disorders is the first priority.
Simple or linear fractures are usually not treated.
Breaks to the upper jaw and cheekbone are generally re-aligned and if necessary, pinned.
Depressed skull fractures need to be surgically repaired.
Painkillers to relieve discomfort.
Oxygen to assist with breathing.
Steroids may be prescribed to reduce brain swelling.
It can take many months for your cat to recover from a skull fracture or head injury. He will need to be kept indoors while he recuperates. Follow-up visits and x-rays will be necessary to track your cat’s progress.
Liquid or tablet painkillers may be necessary for continued pain relief.