What are the symptoms of skull and face fractures?
Skull and facial fractures cause focused pain or a felt step-off at the injured bone, rapid swelling and bruising, and sometimes visible deformity such as a flattened cheek, crooked nose, or teeth that no longer meet. Warning signs of a deeper injury include double vision, facial numbness, clear fluid from the nose or ears, and bruising around both eyes or behind the ear.
What a Fracture Feels and Looks Like
The most common symptoms are focused pain and tenderness directly over the injured bone, sometimes with a step-off — an edge or dent you can feel where the bone has shifted. Swelling and bruising usually appear quickly. Because facial bones are close to the surface, a fracture may also produce a visible change in shape: a flattened cheekbone, a crooked or shifted nose, or a sunken eye. If the jaw or the bones around the teeth are involved, the teeth may no longer meet correctly when you bite down.
Symptoms That Reveal a Deeper Problem
Certain symptoms matter more than the pain itself because they point to injury of the structures the bone protects:
- Double or blurred vision, or trouble moving the eye — suggests an eye-socket (orbital) fracture trapping the muscles that move the eye
- Numbness of the cheek, upper lip, gums, or forehead — a facial nerve running through the bone has been injured
- Bleeding from the ear, or a nosebleed that will not stop — can accompany a fracture at the base of the skull
- Thin, clear fluid draining from the nose or ears — may be cerebrospinal fluid leaking, a sign the fracture reaches the space around the brain
Bruising Patterns That Are Warning Signs
Two specific bruising patterns are classic signs of a skull-base fracture and should never be ignored: bruising around both eyes (“raccoon eyes”) and bruising behind the ear (Battle’s sign). These often appear hours after the injury, so their absence right away does not rule out a fracture.
Overlap With Brain-Injury Symptoms
Because the force that breaks head bone can also shake the brain, fracture symptoms frequently arrive alongside concussion or brain-injury signs: headache, confusion, drowsiness, nausea, or vomiting. These symptoms can develop or worsen in the hours after the injury, which is why symptoms that seemed minor at first still deserve attention if they progress.
For a complete guide, see our skull and face fractures page. Bellaire ER is open 24/7 at 5302 Bellaire Blvd with on-site CT and X-ray to identify what is behind your symptoms — walk in any time, or call (713) 660-0001.