A man sustained injury and presented with fluid coming out through nose. What could be the possible fracture: March 2007

Ans. A: Fracture base of skull A basilar skull fracture/Basal skull fracture) is a linear skull fracture involving the base of the skull. It is most often associated with leakage in the cerebrospinal fluid of the brain into the ear (CSF otorrhea) or the nose (CSF rhinorrhea). These signs are pathognomonic for basilar skull fracture. Basilar skull fractures commonly involve the roof of the orbits, the sphenoid bone, or poions of the temporal bone. Due to the proximity of the cranial nerves, injury to those nerves may occur.This can cause palsy of the facial nerve or oculomotor nerve or hearing loss due to damage of cranial nerve VIII. Clinical manifestations: Battle's sign - is ecchymosis of the mastoid process of the temporal bone. Raccoon eyes - is periorbital ecchymosis i.e. "black eyes" Cerebrospinal fluid rhinorrhea Cranial nerve palsy Bleeding from the nose and ears Hemotympanum Non-displaced fractures usually heal without intervention.