You note thin, bloody drainage from a patient’s ear after head trauma. This finding most likely indicates which of the following?

• A. a linear skull fracture and a significant increase in intracranial pressure
• B. rupture of the tympanic membrane following diffuse impact to the head
• C. significant pressure and bleeding in between the skull and dura mater
• D. fractures to the internal structures of the ear following direct trauma

Answer: (B)

Rupture of the tympanic membrane from blunt head trauma is the most likely explanation for thin, bloody drainage from the ear. When the tympanic membrane tears, blood from the middle ear can seep into the external auditory canal, presenting as a small amount of bloody drainage. This pattern fits trauma-related bleeding from the ear itself.

By contrast, a basilar skull fracture often causes cerebrospinal fluid (CSF) otorrhea, which is clear or has a salty taste, not simply bloody drainage. Other injuries, like a fracture inside the ear or a broad skull fracture with raised intracranial pressure, would produce different signs such as hearing loss, vertigo, or more extensive neurological findings rather than straightforward bloody ear drainage.