Which fracture involves a fracture at the base of the skull with classic late signs?

• A. Basilar Skull Fracture
• B. Raccoon Eyes
• C. Battle Sign
• D. Cerebral Edema

Answer: (A)

Basilar skull fracture involves the base of the skull and is famous for showing delayed, subtle signs as blood and fluid track into tissues at the skull base. The most classic late signs are raccoon eyes (periorbital ecchymosis) and Battle’s sign (ecchymosis behind the ear over the mastoid). These signs develop after the injury as blood accumulates in dependent areas near the skull base, signaling a fracture in that region. In addition, there can be CSF leakage from the nose or ears and possible cranial nerve issues, but the defining feature is the fracture at the skull base with these late signs. The other options describe signs or conditions rather than the fracture itself—racoon eyes and Battle’s sign are manifestations linked to basilar fractures, while cerebral edema is brain swelling and not a fracture.