Medical history Male, 82 years, reported self-height fall at home 8 hours prior to admission, without conscience loss. At first examination he presented a clear airway, no respiratory abnormalities, hemodynamic stability, Glasgow Come Scale of 15, isochoric and photoreactive pupils and a blunt cut injury on the right frontal region. The neurologic examination was normal. He denied comorbidities and medication use. A CT of the skull and face was performed, showing the following images. Image 1: Non-contrast-enhanced CT of the skull, axial view at the level of the frontal sinus, bone window.Image 3: Non-contrast-enhanced facial CT, sagittal view with right paramedian reconstruction, bone window. Image 2: Non-contrast-enhanced CT of the skull, axial view at the ventricular level (A) and supraventricular level (B), brain window. Question: Considering the clinical history and the presented images, which is the correct approach at the moment? Hospital discharge and ambulatory following. Clinical observation in the first hours, followed by home observation for 24 hours. Neurosurgery intervention. Intensive care in the first 12 to 24 hours. Test question (Instituto de Assistência Médica ao Servidor Público Estadual - SP, 2015) The clinical sign of base of skull fracture is: Chin ecchymosis. Unilateral periorbital ecchymosis. Nose wing ecchymosis Mastoid and retroauricular ecchymosis. Ecchymosis on the frontal region. Time is Up! Time's up
