Battle’s sign is a bruise behind one or both ears that indicates a basilar skull fracture caused by acute head trauma. It can lead to intracranial hemorrhage and even death. Other physical signs and neurological symptoms are also considered to diagnose a skull fracture. Treatment plans depend on the severity of the injury and can range from bed rest to surgical procedures. Motor vehicle or bicycle accidents, falls, severe blows to the head, or physical abuse are some of the leading causes of skull fractures resulting in the appearance of the battle mark.
Named after a British physician, Battle’s sign, also known as a mastoid ecchymosis, is a physical sign of trauma to the head that could be indicative of a brain injury. An ecchymosis is a bruise that appears on the surface of the skin and is caused by blood leaking into the tissue from broken blood vessels. Battle’s sign bruise appears behind one or both ears and is an indication of a basilar skull fracture caused by acute trauma to the head. The battle mark will normally develop within 24 to 36 hours after the head injury and may be visible for several weeks. A blow to the head hard enough to produce the Battaglia sign could cause injury to the cranial nerves, brainstem, and lead to intracranial hemorrhage and even death.
Battle’s sign is named after Dr. William Henry Battle, an English surgeon who studied cases of head trauma involving concussions and optic neuritis, which is inflammation of the eye. His studies led him to discover that the physical sign of a bruise behind the ear was indicative of a basilar skull fracture. Although Battle’s sign is an indicator of head injury, other physical signs and neurological symptoms are considered to properly evaluate and diagnose a skull fracture.
When the physical or neurological signs of a skull fracture are found on a physical examination by a doctor, an X-ray or topographic scan is often requested to diagnose the severity of the head injury. Once the severity of the skull fracture has been assessed, a treatment plan is determined. If the skull fracture is not serious, bed rest for several days to a few weeks is often recommended. A more serious head injury might require a surgical procedure, known as a craniotomy, to remove blood clots that have formed in the brain.
Motor vehicle or bicycle accidents, falls, severe blows to the head, or physical abuse are some of the leading causes of skull fractures resulting in the appearance of the battle mark. Other physical signs of head injury are leaking cerebrospinal fluid (CSF) from the ears or nose, the appearance of a purplish discoloration surrounding the skin around the eyes called raccoon eyes, or different pupil sizes. Doctors monitor all of these symptoms to determine whether a traumatic skull or brain injury has occurred. Slurred speech, disorientation, and decreased alertness could be signs of a skull fracture or brain injury. A head injury accompanied by the battle sign could be life-threatening and suggest underlying brain trauma and should be checked for immediate medical attention.
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