Advanced Trauma Life Support (ATLS) Practice Exam 2025 - Free ATLS Practice Questions and Study Guide

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What is a potential indication of a basilar skull fracture?

Raccoon eyes

The presence of raccoon eyes, also known as periorbital ecchymosis, is a potential indication of a basilar skull fracture. This characteristic finding occurs due to the accumulation of blood around the eyes resulting from leakage of blood into the soft tissues surrounding the orbits. It typically manifests a few hours after the injury and can indicate underlying cranial fracture and injury to blood vessels, particularly those at the base of the skull.

While other options like blood in the nares and hearing loss could also occur with a basilar skull fracture, raccoon eyes are more specific and visually indicative of such an injury. Carbonaceous sputum, on the other hand, is associated with inhalation injuries rather than directly indicating a skull fracture. Hence, raccoon eyes serve as a clear and recognizable sign that should prompt further evaluation for possible basilar skull fracture.

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Carbonaceous sputum

Hearing loss

Blood in the nares

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