Which type of skull fracture does the nurse suspect when there is leakage of fluid from a patient's nose and ears?

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

Answer: (B)

Leakage of fluid from the nose or ears points to a tear in the dura at the base of the skull, known as a basilar skull fracture. The base of the skull is where the dura is most vulnerable to trauma, so a fracture there can create a direct path for cerebrospinal fluid to escape, resulting in rhinorrhea (nose) or otorrhea (ears). This finding is a hallmark of skull-base injury and carries a risk of meningitis, so it prompts careful evaluation and protective precautions.

Other skull fractures—linear, depressed, or comminuted—affect different parts or configurations of the skull and do not inherently involve tearing the dura at the skull base to produce CSF leakage from the nose or ears.