Know the signs of basilar skull fracture

On Behalf of Miller, Rosnick, D'Amico, August & Butler

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Jan 27, 2020

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Motor Vehicle Accidents

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Head trauma is fairly common during a motor vehicle accident. A blow to the back of the head can result in a fracture at the base of the skull. If you receive immediate medical attention for a basilar skull fracture, your prognosis will usually be good.

A basilar skull fracture can produce several distinctive signs. They are fairly easy to recognize if you know what to look for.

Battle’s sign

Medical conditions are sometimes named after the doctors who discovered them. Such is the case with Battle’s sign, which takes its name from an English physician. Also known as periauricular ecchymosis, Battle’s sign is a bruise that occurs behind the ear, curving around it in a crescent shape. Battle’s sign can affect either or both ears.

The bruising associated with Battle’s sign is not the result of direct trauma to the ear. The cause is blood from a broken bone pooling in the area. It can be a matter of days after the injury before Battle’s sign shows up.

Periorbital ecchymosis

Whereas Battle’s sign occurs behind the ears, periorbital ecchymosis occurs around the eyes. Like Battle’s sign, it consists of dark reddish-purple bruising that can extend from the area around the eyes onto the cheeks and forehead. The condition also goes by the colloquial name “raccoon eyes” because it mimics the distinctive markings of the North American mammal.

While periorbital ecchymosis can be a sign of basilar skull fracture, it can also result from direct trauma to the face. However, as with Battle’s sign, symptoms are the result of blood pooling in the tissues. Therefore, it can take some time after the accident for the distinctive bruising pattern of raccoon eyes to develop. Additional symptoms may also be present, such as double vision, nosebleeds, hearing loss or weakened sense of smell.

Prompt medical treatment for a basilar skull fracture is very important. Otherwise, it could result in complications, such as meningitis or permanent brain injury.