The most reliable clinical manifestations for diagnosing skull base fractures are not present in every patient, so diagnosing skull base fractures based on clinical manifestations is not particularly reliable. For example, for anterior cranial fossa fractures in skull base fractures, some patients present with the classic battement sign, and there may be a cerebrospinal fluid leak. For fractures of the posterior cranial fossa, the typical batte’s sign can be demonstrated, but it is not always present in some patients. Therefore, the most reliable diagnosis of skull base fractures is based on a clear history of trauma to the head, combined with the possible clinical manifestations, such as the panda-eye sign, the battle sign, cerebrospinal fluid leakage, cranial CT, and three-dimensional imaging, to diagnose the skull base fracture most reliably.