Which finding indicates a basilar skull fracture characterized by bruising behind the ear?

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

Answer: (C)

Battle sign is bruising behind the ear and is a classic indicator of a basilar skull fracture. This sign occurs when bleeding tracks into the soft tissues around the mastoid process after a fracture at the base of the skull, often from the temporal bone. It warns clinicians to look for additional base-of-skull injury signs, such as potential CSF leakage from the ear, and possible cranial nerve involvement. While raccoon eyes can also accompany basilar fractures, the bruising specifically behind the ear identifies this type of injury. The other findings describe general signs of brain injury or increased intracranial pressure and are not specific indicators of basilar skull fracture with mastoid bruising.