Battle Sign refers to bruising behind the ear over the mastoid process.

• A. Battle Sign
• B. Raccoon Eyes
• C. Cushing Triad
• D. Decerebrate Posturing

Answer: (A)

Battle sign is bruising behind the ear over the mastoid process, a hallmark of basilar skull fracture, typically involving the temporal bone. Blood tracks into the mastoid soft tissues after the fracture, so the bruising often appears several hours after injury. This localized post‑auricular bruising is why it’s the best match for the description.

Raccoon eyes describe periorbital bruising around the eyes, not behind the ear. Cushing triad (high blood pressure with bradycardia and irregular respirations) signals raised intracranial pressure in general, not a specific bruise. Decerebrate posturing is an abnormal motor response indicating brainstem injury, not a superficial facial/retroauricular sign.

If Battle sign is present, suspect basilar skull fracture and pursue appropriate imaging and precautions to protect airway and avoid procedures that could worsen a skull base injury.