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Battle's sign, also known as mastoid ecchymosis, is a late indication of
fracture Fracture is the appearance of a crack or complete separation of an object or material into two or more pieces under the action of stress (mechanics), stress. The fracture of a solid usually occurs due to the development of certain displacemen ...
of
middle cranial fossa The middle cranial fossa is formed by the sphenoid bones, and the temporal bones. It lodges the temporal lobes, and the pituitary gland. It is deeper than the anterior cranial fossa, is narrow medially and widens laterally to the sides of the skull ...
of the
skull The skull, or cranium, is typically a bony enclosure around the brain of a vertebrate. In some fish, and amphibians, the skull is of cartilage. The skull is at the head end of the vertebrate. In the human, the skull comprises two prominent ...
, appearing as bruising over one or both of the mastoid processes at least one day after the injury. Such fractures can be associated with underlying brain trauma, as they appear as a result of extravasation of blood along the path of the
posterior auricular artery The posterior auricular artery is a small artery that arises from the external carotid artery. It ascends along the side of the head. It supplies several muscles of the neck and several structures of the head. Structure Origin The artery ar ...
. The sign is named after William Henry Battle. Battle's sign is considered a late sign, as it takes at least one day to appear after the initial traumatic
basilar skull fracture A basilar skull fracture is a bone fracture, break of a bone in the base of skull, base of the skull. Symptoms may include Battle sign, bruising behind the ears, periorbital ecchymosis, bruising around the eyes, or hemotympanum, blood behind the ...
, similar to
raccoon eyes Raccoon eyes, also known as panda eyes or periorbital ecchymosis, is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers. Bilateral hemorrhage occurs when damage at the time ...
.Handbook of Signs & Symptoms (Third Edition) Battle's sign may be confused with a spreading
hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries. A hematoma is ...
from a fracture of the mandibular condyle, which is a less serious injury.


See also

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Basilar skull fracture A basilar skull fracture is a bone fracture, break of a bone in the base of skull, base of the skull. Symptoms may include Battle sign, bruising behind the ears, periorbital ecchymosis, bruising around the eyes, or hemotympanum, blood behind the ...
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Raccoon eyes Raccoon eyes, also known as panda eyes or periorbital ecchymosis, is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers. Bilateral hemorrhage occurs when damage at the time ...
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Black eye A periorbital hematoma, commonly called a black eye or a shiner (associated with boxing or stick sports such as hockey), is bruising around the eye commonly due to an injury to the face rather than to the eye. The name refers to the dark-colo ...


References

Traumatology Injuries {{med-sign-stub