Periorbital ecchymosis and mastoid discoloration are classic signs of?

• A. Increased ICP.
• B. Orbital injury.
• C. TMJ discoloration.
• D. Basilar skull fracture.

Answer: (D)

Basilar skull fracture presents with signs that reflect blood tracking to tissues at the base of the skull. Periorbital ecchymosis (raccoon eyes) and behind-the-ear discoloration (mastoid ecchymosis or Battle’s sign) are classic manifestations because blood from the fracture can diffuse into the soft tissues around the eyes and the mastoid region. These signs strongly point to a skull base injury and often accompany other basilar signs such as CSF leakage from the nose or ear and hemotympanum. They indicate potential intracranial involvement and the need for prompt imaging and careful monitoring. Other options describe different scenarios—increased intracranial pressure signs are not specific to basilar fractures, orbital injury would focus on the eye itself, and TMJ discoloration isn’t tied to skull base trauma.