When assessing a patient with multiple trauma, which sign would most suggest a head injury?

Battle's sign is the most indicative of a head injury, particularly in cases of skull base fractures. This sign is characterized by bruising over the mastoid process behind the ear and indicates underlying hematoma formation, often associated with traumatic brain injury. It often appears within 24 hours following a head injury and is a critical clinical sign that prompts immediate further evaluation of potential intracranial damage.

The other signs, while important in their own rights, correlate with different types of trauma. Grey Turner's sign, which indicates retroperitoneal hemorrhage, and Cullen's sign, which suggests abdominal bleeding, are both related to abdominal injuries rather than head injuries. Abdominal distension can result from various abdominal traumas or conditions but does not specifically relate to head trauma. Understanding these distinctions is vital for effective trauma assessment and prioritization of treatment in critically injured patients.