From the Research
The four classic signs of a basilar skull fracture are raccoon eyes (periorbital ecchymosis), Battle's sign (retroauricular ecchymosis), cerebrospinal fluid (CSF) rhinorrhea, and CSF otorrhea, as identified in the most recent study 1. These signs are crucial for early detection and management of basilar skull fractures, which can lead to serious complications such as meningitis, brain injury, and cranial nerve damage.
Key Signs of Basilar Skull Fracture
- Raccoon eyes: bruising around the eyes due to blood tracking from the anterior cranial fossa fracture into the periorbital tissues
- Battle's sign: bruising behind the ear over the mastoid process, indicating blood from a temporal bone fracture
- CSF rhinorrhea: clear fluid leaking from the nose when the dura is torn, allowing CSF to drain through fractures in the cribriform plate or frontal sinus
- CSF otorrhea: clear fluid draining from the ear due to dural tears associated with temporal bone fractures The presence of any of these signs warrants immediate medical attention, and diagnosis is typically confirmed with CT imaging, as noted in 2 and 1. Management focuses on preventing complications while allowing the fracture to heal, with conservative management attempted first, and surgical management considered if necessary, as discussed in 3 and 1.