Which sign is used to indicate possible CSF leakage in a patient with a suspected skull fracture?

• A. Halo sign
• B. Battle sign
• C. Raccoon sign
• D. Linear sign

Answer: (A)

CSF leakage after head trauma is suggested when clear fluid drains and forms a halo around a blood stain on a dressing. The halo sign occurs because CSF mixes with blood, creating a ring of yellowish fluid around the central blood spot. This directly indicates CSF drainage, making it the best choice among the options. Signs like behind-the-ear bruising or around the eyes reflect a basilar skull fracture but don’t prove CSF leakage, and the linear sign isn’t a recognized CSF-leak indicator. If you observe a halo around a blood stain, treat the situation as possible CSF leak, monitor the airway, and transport promptly for further evaluation.