Raccoon eyes
Raccoon eyes (also known in the UK as panda eyes) or periorbital ecchymosis is a sign of basal skull fracture, a craniotomy that ruptured the meninges, or (rarely) certain cancers.[1][2] Bilateral subconjunctival hemorrhage occurs when damage at the time of a facial fracture tears the meninges and causes the venous sinuses to bleed into the arachnoid villi and the cranial sinuses. In layman's terms, blood from skull fracture seeps into the soft tissue around the eyes. Raccoon eyes may be accompanied by Battle's sign, an ecchymosis behind the ear. These signs may be the only sign of a skull fracture, as it may not show on an X-ray. They may not appear until up 2–3 days after the injury.[3] It is recommended that the patient not blow their nose, cough vigorously, or strain to prevent further tearing of the meninges.[4]
Raccoon eyes may also be a sign of disseminated neuroblastoma[5] or of amyloidosis (multiple myeloma). It can also be a side effect of using cocaine.[citation needed]
Depending on cause, raccoon eyes always require urgent consultation and management, that is surgical (facial fracture or post-craniotomy) or medical (neuroblastoma or amyloidosis).
[edit] References
- ^ Herbella, FA; Mudo M, Delmonti C, Braga FM, Del Grande JC (December 2001). "'Raccoon eyes' (periorbital haematoma) as a sign of skull base fracture". Injury 32 (10): 745–7. doi:10.1016/S0020-1383(01)00144-9. PMID 11754879.
- ^ EMT Prehospital Care (4th Edition)
- ^ Handbook of Signs & Symptoms (Third Edition)
- ^ Nursing: Interpreting Signs and Symptoms
- ^ Gumus K (2007). "A child with raccoon eyes masquerading as trauma". Int Ophthalmol 27 (6): 379–81. doi:10.1007/s10792-007-9089-y. PMID 17534581.
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