Search

William Henry Battle (1855-1936) was a remarkable physician, who is most remembered for his “sign” (post-auricular ecchymosis indicating a fracture of the base of the skull). However, there were many of his contributions to the medical knowledge. This paper aims to describe his brief history, emphasizing on the Battle’s sign.

An 8-month-old girl presented with a right raccoon eye and right Battle’s sign ([figure 1A,B][1]), which are signs of a basal skull fracture,[1][2] after a fall from a height of 40 cm the previous day. A head thin-slice CT scan revealed a right parietal bone simple fracture ([figure 1C,D][1])

William Henry Battle (1855–1936) practiced medicine in England > 1 century ago and is primarily remembered for his description of ecchymosis over the mastoid, which indicates fracture of the skull base. Although Mr. Battle made many contributions to medicine, almost nothing exists in the literature regarding his life and findings, especially in regard to head injury. The following is a review of Battle's background and his contributions to medicine, specifically his observations associated with basilar skull fractures.

Battle’s sign is a classical clinical sign that has long been held to be synonymous with fracture of the basal skull. As such the presence of Battle’s sign is a strong indicator that a basal skull fracture could be present in the head injured patient, as exemplified by its inclusion as a major risk factor in scoring systems designed to assess the likelihood of basal skull fracture. We present a case that describes the occurrence of this classic clinical sign in an unlikely setting and, for the first time since it was described more than 120 years ago, re-examine the pathologic basis for its appearance.

A 46-year-old man presented to the otolaryngology clinic with hearing loss and a sensation of fullness in the left ear. The symptoms had started a few days before presentation.