应对颅骨骨折患者定期随访(最初约每 2-3 个月),进行临床检查以评估持续存在的神经系统症状并监测迟发型癫痫发作的证据。还应对患者随访以监测颅神经损伤的消退。如果症状持续存在,可能需要进行延迟减压手术。感染风险极高的患者还应接受实验室检测〔包括全血细胞计数 (FBC)〕并重复进行影像学检查以排除颅内感染;这包括骨折累及额窦和上颌窦的患者,或使用金属硬件修补骨折后的患者,因为可能出现脓肿或黏脓液囊肿。[69]Sivori LA 2nd, de Leeuw R, Morgan I, et al. Complications of frontal sinus fractures with emphasis on chronic craniofacial pain and its treatment: a review of 43 cases. J Oral Maxillofac Surg. 2010;68:2041-2046.http://www.ncbi.nlm.nih.gov/pubmed/20728027?tool=bestpractice.com还应每 2 个月定期对儿童(特别是 3 岁以下)进行重复性影像学检查,以监测生长性颅骨骨折。在长达 2-3 个月期间,应采用 CT 扫描随访严重污染的开放性颅骨骨折,以排除颅内脓肿。[3]Ersahin Y, Mutluer S, Mirzai H, et al. Pediatric depressed skull fractures: analysis of 530 cases. Childs Nerv Syst. 1996;12:323-331.http://www.ncbi.nlm.nih.gov/pubmed/8816297?tool=bestpractice.com[41]Donovan DJ. Simple depressed skull fracture causing sagittal sinus stenosis and increased intracranial pressure: case report and review of the literature. Surg Neurol. 2005;63:380-383.http://www.ncbi.nlm.nih.gov/pubmed/15808730?tool=bestpractice.com[55]Bullock MR, Chesnut R, Ghajar J, et al; Surgical Management of Traumatic Brain Injury Author Group. Surgical management of depressed cranial fractures. Neurosurgery. 2006;58(3 suppl):S56-S60.http://www.ncbi.nlm.nih.gov/pubmed/16540744?tool=bestpractice.com