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A skull or cranial fracture is one of the most dangerous birth injuries your child can suffer during the birthing process. Skull fractures take place when the delivering physician or nurse uses too much force for one reason or another and fracture or crack a part of the baby’s skull. The baby’s cranium, which is made up of small bones that eventually fuse into an adult skull, is a protective part of a baby’s body that keeps the brain safe from trauma or injury. The bones that can be broken or fractured are called the ethmoid (behind the eye socket, towards the nose), sphenoid (behind the eye socket, toward the temple), occipital (back of the skull where it bends inward), temporal (sides of the head), parietal (top of head down to occipital bone), and frontal (forehead) bones. In addition to affecting the brain, a skull fracture can also distress the spinal cord and spine and cause paralysis.
One of the main causes of a skull fracture is due to the pressure around the skull as it passes through the birth canal. These types of fractures cannot always be prevented. Another cause of newborn skull fracture is when the mother’s pelvic structure compresses the baby’s skull as it exits the womb. This is another type of fracture that is not always preventable. However, both of these types of fractures usually happen after the mother has shown signs of a traumatic delivery. In some cases, an emergency Caesarian section will prevent the baby from having his or her skull fractured. Also, naturally birthing the baby instead of using assistive devices, like a vacuum extractor and forceps, can prevent skull fracturing.
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As mentioned, there are six different cranial bones that can break, but they are classified in only three different groups.
The first is known as a linear skull fracture. A linear skull fracture is a hairline break on the cranial bone. It does not splinter, nor does it cause a depression in the skull or any type of bone distortion. It most often affects the parietal bone, but it can also happen to the frontal and occipital bones. A linear skull fracture is often associated with cephalhematoma, otherwise known as swelling of the head, caused by blood hemorrhaging between the skull and the layer just beneath the skin.
Generally, a linear skull fracture is the result of a delivery aided by assistive instruments, such as forceps or a vacuum extractor. When a linear skull fracture happens, a CT scan should be immediately completed to check for an epidural hematoma. Medical malpractice can occur when the CT scan is not completed and the fracture is not properly treated. If properly cared for, this type of skull fracture usually heals within a month or two; follow-up appointments are then required to rule out any other issues for as long as your pediatrician recommends.
A depressed skull fracture happens when the baby’s skull crumples inward towards the baby’s brain. This may be caused by severe compression during labor. A simple depressed skull fracture may be treated by pulling the depressed bone back up into place with surgery. A simple depressed fracture will not necessarily do brain damage to the baby, but the baby’s head may end up deformed as he or she grows older. However, some simple depressed fractures have been known to cause seizures and other neurological disorders later in the child’s life. In some cases, the bone will even work itself back into place, though this is rare.
In severe cases of a depressed skull fracture in a newborn, bone fragments can end up in the cerebrum or brain tissue and cause serious neurological defects, dural tears, and cerebrospinal fluid leaks. In these cases, surgery should be performed as soon as possible. An infant should be prescribed a CT scan immediately after the depressed skull fracture is diagnosed to see if there is any intracranial hemorrhaging. Medical malpractice can occur when a depressed skull fracture is not immediately diagnosed and thus not properly treated, causing the baby severe damage that is usually degenerative and sometimes fatal.
Occipital separation, otherwise known as occipital osteodiastasis, is a rare complication that takes places during cephalic presentation or delivery. This basically means that the first part of the baby’s body through the pelvis and birth canal is the occipital bone, or the lower back of the baby’s head. Occipital separation can cause what is known as “posterior fossa subdural hemorrhaging,” which is a type of bleeding in the brain that is rarely immediately diagnosed. Symptoms are usually lethargy and extreme irritability within the first few days of life, followed by other worsening symptoms and an enlarged head as the baby grows. Occipital osteodiastasis can also cause lacerations to the cerebellum. Medical malpractice can occur when the baby is not properly removed from the mother’s vagina and when the baby is not properly diagnosed within the first hours of his or her life.
At Richards & Richards, LLP, we have been helping families with babies who were born with injuries due to medical malpractice for more than fifty years. Attorney Veronica Richards is both a nurse practitioner and an experienced medical malpractice lawyer who has helped hundreds of people and their families who have been injured because of the negligence of a physician or other healthcare workers. Call Richards & Richards, LLP today for a free consultation at 412-261-2620, or you can contact us online today.