Epidemiology

Skull fractures occur in 2% to 20% of all head trauma.[2][3]​ According to data from the Global Burden of Disease Study 2019, the age-standardized rates of skull fractures were 98.9 incident cases (77.1 to 128.5) per 100,000 population and 39.9 prevalent cases (35.7 to 45.8) per 100,000 population.[4]​ Skull fractures occur most frequently between the ages of 20 and 50 years.[5] However, children with a head injury have an increased prevalence of skull fracture in comparison with adults. Males are overwhelmingly more commonly affected than females.[4][6][7][8]​​​​ The most common mechanism, found in up to 35% of cases, is a fall.[5][9][10]​​​ The most common fractures are simple linear fractures, found in up to 50% to 80% of all skull fractures.[2][9][11]

Risk factors

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fall from height

Most common cause of skull fractures for both adults and pediatric patients, accounting for up to 28% to 35% of all skull fractures.[5][9]

motor vehicle accident

Second most common cause of skull fractures, accounting for 20% to 25% of all fractures.[2][5][6][9]

assault resulting in head trauma

A common cause of fractures, accounting for up to 30% of skull fractures in adults.[12] Abusive head trauma is the third leading cause of head injury in children younger than 5 years, only surpassed by motor vehicle collisions and falls.[16]​[21]​​​ It is also the leading cause of severe head injury in infancy.[21] The incidence of skull fractures in outpatients in children presenting for evaluation of head trauma ranges from 2% to 20% and occurs at a higher incidence in younger children (particularly those younger than 1-2 years).[3]

gunshots to the head

An uncommon cause of skull fracture, but when present a gunshot wound to the head has a high chance of causing a fracture.[Figure caption and citation for the preceding image starts]: Transcranial gunshot woundFrom the teaching collection of Demetrios Demetriades; used with permission [Citation ends].Transcranial gunshot wound[Figure caption and citation for the preceding image starts]: Gunshot wound with comminuted elevated fracture and pneumocephalusFrom the teaching collection of Demetrios Demetriades; used with permission [Citation ends].Gunshot wound with comminuted elevated fracture and pneumocephalus[Figure caption and citation for the preceding image starts]: Gunshot wound with perpendicular blowout fractureFrom the teaching collection of Demetrios Demetriades; used with permission [Citation ends].Gunshot wound with perpendicular blowout fracture

male sex

Males predominate, with risk at least 1.5 times that of females of equivalent demographics, and account for up to 71% of all skull fractures.[6][8]

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