Which finding indicates cerebrospinal fluid leakage in suspected basilar skull fracture?

Which finding indicates cerebrospinal fluid leakage in suspected basilar skull fracture?

• A. Halo Sign
• B. Battle Sign
• C. Hemotympanum
• D. Racoon Eyes

Answer: (A)

CSF leakage is suggested when a clear fluid drains and forms a halo around a central blood stain on gauze. The halo occurs because CSF diffuses around the blood, creating a distinct clear ring that distinguishes CSF from ordinary nasal or ear drainage. This bedside clue is particularly important in suspected basilar skull fracture, where a leak increases infection risk and requires confirmation (for example, with beta-2 transferrin testing or imaging). Other signs like postauricular ecchymosis (Battle sign), periorbital ecchymosis (raccoon eyes), and hemotympanum indicate a basal skull fracture but do not specifically confirm CSF leakage.

CSF leakage is suggested when a clear fluid drains and forms a halo around a central blood stain on gauze. The halo occurs because CSF diffuses around the blood, creating a distinct clear ring that distinguishes CSF from ordinary nasal or ear drainage. This bedside clue is particularly important in suspected basilar skull fracture, where a leak increases infection risk and requires confirmation (for example, with beta-2 transferrin testing or imaging). Other signs like postauricular ecchymosis (Battle sign), periorbital ecchymosis (raccoon eyes), and hemotympanum indicate a basal skull fracture but do not specifically confirm CSF leakage.