Which type of skull fracture is defined as a fracture at the base of the skull?

• A. Basilar skull fracture
• B. Linear skull fracture
• C. Depressed skull fracture
• D. Comminuted skull fracture

Answer: (A)

Recognizing where the injury occurs is what this item tests. A basilar skull fracture is a fracture at the base of the skull—the bottom portion that forms the floor of the cranial cavity. This location distinguishes it from fractures that occur in the top or sides of the skull. Other patterns describe how the bone breaks rather than where: a linear skull fracture is a single, straight-line break through a skull bone; a depressed skull fracture involves a fragment being pushed inward toward the brain; and a comminuted skull fracture has multiple fragments at the fracture site. Because the defining feature here is the fracture’s location at the skull base, basilar skull fracture is the correct description. Clinically, signs such as raccoon eyes, Battle’s sign, or CSF leakage from the nose or ear can accompany basilar skull fractures, but the key characteristic is the base-level location of the fracture.