In skull fracture it is clinically important that the mechanical force which produce skull fracture might also produce brain injury, that cosmetic outlook is important, and that above all there are many complications. In the diagnosis of complications of skull fracture it will be useful to know the mechanical background.
Skull fracture occurs at the compression load of about 500 kg or load factor of about 100. Fracture may occur experimentally when the head dropped from the height of 100 cm onto the hard impact surface and from accident surveys when the impact speed exceeds 10 to 15 km/hr.
Skull fracture begins at the impact point and the fracture lines run along the direction of mechanical force. The fracture in the skull base follows the same principle with some variations according to the structural weakness. Therefore, there are particular symptoms and signs according to the relationship between impact points and the anatomy. For the convenience of the diagnosis the site of blow are divided into facial, mid frontal, lateral frontal, lateral, posterior lateral, occipital, and vertex blow.
Considering the direction of mechanical force, it is possible to recognize symptoms and signs as a pattern in the diagnosis of skull fracture and its complications.