Basilar Skull Fracture

A basilar skull fracture means there is a break or crack in one of the bones that make up the bottom (base) of the skull. Usually, the pieces of bone do not move out of place. The fracture is just a thin line that separates the bone. Basilar skull fractures often happen in the bones around the ears, nose, under the eyes, or near the upper spine.


Most of the time, a basilar skull fracture is caused by a blow or forceful injury to the head. This could happen from:

  • A car crash.

  • Physical violence.

  • A fall from a high place.


Symptoms of a basilar skull fracture depend on where the fracture occurs. They also depend on what is near the fracture, such as blood vessels, nerves, and cerebrospinal fluid. Cerebrospinal fluid is the clear liquid that normally flows around the brain and spinal cord. Symptoms may include:

  • Clear liquid leaking or oozing from an ear or the nose.

  • Sudden loss of hearing after an injury.

  • Sudden loss of smell after an injury.

  • Blurred or double vision.

  • Trouble with balance or coordination.

  • Headache.

  • Nausea or vomiting.

  • Weakness or numbness in the face.

  • Bruises around the eyes.

  • Bruises behind the ear.

  • Blood leaking from the ear.


Computed tomography (CT) is the best way to tell if you have a basilar skull fracture. Your caregiver may also:

  • Take a sample of the fluid leaking from your ear or nose. This fluid will then be tested in a lab.

  • Test your hearing.

  • Check the nerves in your face.


Most basilar skull fractures heal without treatment after several weeks. You may be given medicine for headaches or nausea. Sometimes, surgery is needed in complicated cases.


  • Only take over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your caregiver.

  • Have someone stay with you when you go home. This person will need to observe you closely for the next 48 hours.

  • Keep your head raised when you are lying down.

  • Rest. Avoid any activity that requires extra energy. Ask your caregiver when you can go back to your normal activities.

  • Do not drive until your caregiver says it is okay.

  • Do not drink alcohol until your caregiver says it is okay.

  • Keep all follow-up appointments as directed by your caregiver.


Your symptoms do not go away as expected.


  • Your symptoms get worse.

  • You, your family, or your friends notice you are developing new symptoms.

  • Your family or friends notice you are very drowsy or you are not acting normally.

  • You have a fever.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.