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12253 Surgery

A 43-year-old man presents to the emergency department after falling down a flight of stairs and landing on his head. He did not lose consciousness. He complains of severe headache, marked decreased acuity in hearing in the left ear, and a “runny nose” since the fall. On physical examination, he is found to have a left sided Battle’s sign (an ecchymosis in the area of the left mastoid process) and hemotympanum. He has a constant dripping of a clear, watery fluid through his nose. Findings on his neurologic examination, other than the hearing loss, are completely normal. X-ray studies will reveal which of the following?

AA fracture of the cribriform plate with a CSF leak into the paranasal sinuses
BA skull-base fracture with a mucocele
CA temporal bone fracture with paradoxical rhinorrhea
DOccipital bone fracture
Surgery
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