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 due to 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 a brain injury to occur too.
Types of break:
- 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.
Symptoms
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, this highlights 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:
- Head tilt
- Ataxia (unsteady gait)
- Seizures
- Drowsiness
- 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, and may include:
- Difficulty eating (jaw)
- Broken or missing teeth
- Unable to open or close the mouth (jaw)
- Difficulty breathing through the nose
- Facial swelling of the cheek, nose and jaw
Diagnosis
The 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 CT 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.
Treatment
Treatment will depend on the type and severity of the fracture. The priority is to stabilise the cat and treat neurological disorders (if present).
- No treatment is generally necessary for simple or linear fractures.
- Surgery to re-align and pin breaks to the upper jaw and cheekbone.
- Surgical repair of depressed skull fractures.
Supportive care:
- Painkillers to relieve discomfort.
- Steroids to reduce brain swelling.
Home care
It can take many months for your cat to recover from a skull fracture or head injury and follow-up visits and x-rays will be necessary to track your cat’s progress. Confine the cat indoors during the recovery period.
Painkillers will be necessary to manage pain. Only administer painkillers that have been prescribed by a veterinarian as most painkillers safe for humans are toxic to cats.
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