Which of the following is a sign consistent with basilar skull fracture after head trauma?

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Basilar skull fractures involve the bottom part of the skull and can show several telling signs from trauma. Blood draining from the ear points to injury near the temporal bone and possible CSF leakage, which is a classic clue of a fracture at the skull base. Bruising under the eyes, known as periorbital ecchymosis or “raccoon eyes,” is another classic sign that results from blood tracking to the soft tissues around the orbits after a base fracture. Unequal pupils can occur when there’s cranial nerve involvement or pressure changes from injury to the brain, which can accompany severe base skull fractures. When these signs occur together in the context of head trauma, they collectively indicate a basilar skull fracture, making all of the above the best answer. In the field, treat with spinal precautions, avoid nasal maneuvers or airway devices that could worsen leakage, monitor closely, and transport promptly for imaging and definitive care.