TY - CHAP M1 - Book, Section TI - Basilar Skull Fracture A1 - Stark, Christopher L. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - The skull “base” comprises the frontal bone, occiput, occipital condyles, clivus, carotid canals, petrous portion of the temporal bones, and the posterior sphenoid wall. A basilar skull fracture is basically a linear fracture of the skull base. Trauma resulting in fractures to this area typically does not have localizing symptoms. Indirect signs of the injury may include visible evidence of bleeding from the fracture into the surrounding soft tissues of the base of the head, such as a Battle sign or “raccoon eyes.” Bleeding into other structures, blood in the middle ear causing hemotympanum, or blood in the sphenoid sinus seen as an air-fluid level on CT may also be seen. CSF leaks may also be evident and noted as clear or pink rhinorrhea. If CSF is present, a dextrose stick test may be positive. The fluid can be placed on filter paper, and a “halo” or double ring may be seen. Bedsheets may reveal the halo sign. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/11/01 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1198097671 ER -