b'ChapterFractured Skull / Cerebral CompressionAny trauma to the head can result in a potential skull fracture and/or bleeding within the skull. The skull is a very hard rigid structure and will not expand to accommodate any additional room. If there is a build up of blood or fluid within the skull, the brain may become compressed. This could lead to serious brain damage or death. A fracture to the base of the skull, combined with internal bleeding and cerebral compression may lead to leakage of cerebrospinal fluid. This is the clear fluid that surrounds the brain and it may be seen slowly leaking from the ears, mouth or nose.How to RecogniseBrief or total loss of consciousness.Dizziness, nausea, vomiting, blurred vision.Numbness, tingling sensations, paralysis.The patient may convulse.Discharge of clear fluid (but may be mixedwith blood) from the ears, mouth or nose.Bruising around the eyes or behind the ears.Unequal or sluggish pupil response.There may be bleeding into the whites of the eyes.Breathing may become altered or even cease.How to Manage Concussion and Fractured Skull / Cerebral CompressionConscious PatientCall an ambulance if there has been a loss of consciousness or altered consciousness at any time, no matter how brief. A patient who has sustained a head injury, whether or not there has been loss of consciousness or altered consciousness, should be assessed by a health care professional. Ensure that the airway is clear Protect the neck from movement if possible as there may be a spinal injuryCheck and control any bleeding with direct pressure if possible Check for any other injuriesComfort, rest and reassureWhile waiting for Ambulance, closely monitor patient for response (and any altered conscious state) airway, normal breathing 92 Head, Neck and Spinal Injury'