• Neurocritical care · Jan 2008

    Case Reports

    False-positive presentation of Battle's sign during hepatic encephalopathy.

    • G L Ackland, J O'Beirne, A R Platts, and S C Ward.
    • Department of Intensive Care Medicine, Royal Free Hospital, Pond Street, London, NW3 2QG, UK. gackland@stanford.edu
    • Neurocrit Care. 2008 Jan 1;9(2):253-5.

    IntroductionBattle'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.DiscussionWe 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.

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