Emergency Medical Technician (EMT) Intermediate Practice Exam

Leakage of cerebrospinal fluid (CSF) from the nose after severe head trauma may indicate?

1. Excess fluid buildup

2. Fracture of the cribriform plate

3. Fractured nasal bones

4. Compression of the spinal cord

The correct answer is: Fracture of the cribriform plate

The presence of cerebrospinal fluid (CSF) leaking from the nose after severe head trauma is a strong indication of a fracture of the cribriform plate, which is located at the base of the skull. This plate contains small holes through which the olfactory nerves pass. When trauma occurs, particularly blunt force injury to the forehead or face, it can cause a fracture in this area. Such a fracture can disrupt the integrity of the surrounding structures, allowing CSF to leak through the nasal cavity. This is often accompanied by a condition known as rhinorrhea, where fluid drains from the nose, and may also lead to other clinical symptoms such as the presence of blood or a clear fluid that has a higher specific gravity than mucus. Recognizing a CSF leak is essential, as it signals a potential risk for complications like meningitis, due to the exposure of normally sterile cranial contents to the external environment. Therefore, the clear connection between head trauma and the leakage of CSF specifically points to this type of fracture as the most likely cause.