A patient presents with lethargy, clear nasal drainage, and bruising around the eyes following a motor vehicle accident. What injury is likely?

The presence of lethargy, clear nasal drainage, and bruising around the eyes in a patient following a motor vehicle accident suggests a basilar skull fracture. This type of fracture typically involves a break in the base of the skull, which can lead to several characteristic signs and symptoms.

One notable indicator of a basilar skull fracture is the presence of clear nasal drainage, which may be cerebrospinal fluid (CSF) leaking from the nose due to a breach in the protective coverings of the brain. Bruising around the eyes, known as "raccoon eyes," is another classic sign associated with this type of fracture, indicating possible trauma to the skull base. These symptoms, coupled with lethargy, suggest significant neurological involvement, commonly seen in basilar skull fractures.

Other conditions such as concussions, epidural, and subdural hematomas have different presentations. Concussions typically present with confusion or headache rather than clear nasal drainage or specific bruising. Epidural hematomas often result in rapid neurological decline but are not typically associated with nasal fluid drainage. Subdural hematomas might cause changes in consciousness and bruising, but they don’t usually present with the clear fluid drainage characteristic of basilar skull fractures. Thus, the