In basilar skull fracture, which sign indicates a CSF leak requiring assessment?

• A. Earache with dull ache
• B. Red nasal discharge
• C. Clear rhinorrhea
• D. Earwax buildup

Answer: (C)

CSF leaks occur when the dura is breached after a basilar skull fracture, allowing fluid from the subarachnoid space to drain into the nasal cavity. The sign that points to a CSF leak is clear, watery rhinorrhea that is colorless and may worsen with bending forward or straining. This finding needs assessment because CSF leaks raise the risk of meningitis and should be confirmed (often with a beta-2 transferrin test) and evaluated promptly by specialty care. Other signs like earache with dull pain suggest middle or external ear issues; red nasal discharge points to blood-tinged epistaxis or infection; earwax buildup is unrelated to CSF leakage.