Which indicator suggests a skull fracture?

Blood in the ear canal is a significant indicator that suggests a skull fracture, particularly a fracture involving the base of the skull. This finding, often referred to as "otorrhea" when it involves clear fluid or cerebrospinal fluid (CSF), can indicate that there has been a breach in the bony structures of the skull, allowing blood to escape into the ear canal. It's a crucial clinical sign that prompts further investigation for potential serious brain injuries or complications associated with the trauma.

In contrast, non-reactive pupils can occur due to various neurological conditions and does not specifically indicate a skull fracture. Decorticate posturing is a response to severe brain injury but is not exclusive to skull fractures and can stem from other types of trauma or neurological compromise. Increased blood pressure might be observed in cases of head injury as the body attempts to maintain cerebral perfusion but is not a direct indicator of skull fracture. Thus, the presence of blood in the ear canal is a more specific and concerning symptom indicating possible damage to cranial structures.