Signs and symptoms of a closed head injury include the following.

a. Deformity of the head (skull fracture).

b. Clear or bloody fluid (cerebrospinal fluid) leaking from the nose and/or ear.

c. Periorbital discoloration (“black eyes” or “raccoon eyes”).

d. Bruise behind one or both ears over the mastoid process (Battle’s sign).

e. Slow pulse rate (may not be present if there is significant bleeding elsewhere).

f. Mental confusion or memory loss.

g. Staggering, dizziness, or drowsiness.

h. Increased intracranial pressure (paragraph 5-4).