Raccoon eyes sign (base of skull fracture)

Last revised by Bahman Rasuli on 4 Dec 2020

Raccoon eyes sign (or panda eyes in the UK and Ireland) refers to periorbital ecchymosis with sparing of the tarsal plate 3 and is a physical examination finding indicative of a base of skull fracture of the anterior cranial fossa.

However it is not pathognomonic for trauma, and there are several rare causes described, including metastatic neuroblastoma, Kaposi sarcoma, multiple myeloma, and amyloidosis 2.

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Cases and figures

  • Figure 1: raccoon (photo)
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  • Figure 2: raccoon eyes (sign)
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