Battle´s Sign. More than a Manifestation of Head Trauma Volume 10 - Issue 2

Hector R Diaz*

• Consulting Professor, Idalberto Revuelta University, Policlinic, Sagua la Grande, Villa Clara, Cuba

Received: August 02, 2023;   Published: August 25, 2023

Corresponding author: Hector R Diaz, Consulting Professor., Idalberto Revuelta University, Policlinic. Sagua la Grande, Villa Clara, Cuba

DOI: 10.32474/JAAS.2023.09.000334

Abstract PDF

Figure 1: The Battle´s sign.

The Battle´s sign was initially described by William Henry Battle (1855-1936) it refers to retroauricular ecchymosis on the mastoid, which indicates a fracture of the median base of the skull [1]. This sign is noted as a bruising of the mastoid process as a consequence of extravasation of blood along the path of the posterior auricular artery (Figure 1). This sign typically appears one to three days after the traumatic injury occurs. On the other hand, this type of ecchymosis can also be produced by other non-traumatic causes.

The objective of this communication is to point out the fundamental non-traumatic causes that can produce ecchymosis in the retroauricular region. Causes of non-traumatic ecchymosis in the retroauricular region:

a) Connective tissue disorders (systemic lupus erythematosus; scleroderma; dermatomyositis; polymyositis; rheumatoid arthritis; Ehlers–Danlos syndrome; mixed connective tissue disease.

b) Coagulation disorders (hemophilia, Von Willebrand disease, clotting factor deficiencies, hypercoagulable states and deep venous thrombosis).

c) Hepatic diseases.

d) Chronic kidney disease.

e) Hypothyroidism.

f) Bone marrow disorders.

g) Drugs ( anticoagulants, platelet antiaggregant, steroids)

h) Infection diseases (N. meningitidis; varicella; scarlet fever; rubella; measles; dengue and other haemorrhagic fever).

Battle’s sign was described in the context of medical care for patients with head trauma as a manifestation of the presence of a fracture of the median base of the skull. However, this semi logical sign has been exceptionally observed in patients with pathological processes other than skull fracture.

1. William Henry Battle (1890) Some points relating to injuries to the head. The Lancet.