Raccoon eyes (also known in the United Kingdom and Ireland as panda eyes ) or periorbital ecchymosis is a sign of a basal skull fracture or subgaleal hematoma, a craniotomy rupture in the meninges, or (rarely) certain cancers. Bilateral bleeding occurs when damage to the facial fracture ruptures the meninges and causes the venous sinus to bleed into the arachnoid villi and cranial sinus. In layman's terms, the blood from the skull fractures seeps into the soft tissues around the eyes. Raccoon eyes can be accompanied by a Battle sign, ecchymosis behind the ear. These signs may be the only sign of a skull fracture, as they may not be seen on X-rays. They may not appear until 2-3 days after the injury. It is recommended that the patient not blow his nose, cough hard, or strain to prevent further tearing of the meninges.
Raccoon eyes may be bilateral or unilateral. If bilateral, it is highly suggestive of a basilar skull fracture, with a positive predictive value of 85%. They are most commonly associated with anterior cranial fossa fractures.
Raccoon eye can also be a sign of disseminated neuroblastoma or amyloidosis (multiple myeloma).
Depending on the cause, raccoon eyes always require urgent consultation and management, ie surgery (facial or post-craniotomy) or medical fractures (neuroblastoma or amyloidosis).
Video Raccoon eyes
See also
- periorbital black circle
- Periorbital swelling
- Battle marks
Maps Raccoon eyes
References
Source of the article : Wikipedia
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