Raccoon eyes facial trauma. to adversely affect the airway: .

• Raccoon eyes facial trauma to adversely affect the airway: It can cause peri-orbital ecchymosis (Raccoon eyes), Battle’s sign, CSF rhinorrhea The neonatal lupus erythematosus (vasculitis may lead to facial and periorbital purplish-red plaques) Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated Blood that collects under the eyes due to a fracture in the base of the skull is referred to as ‘raccoon eyes. (b) Clinical features of panfacial trauma (peri-orbital edema, gross facial edema) with emergency intervention (oral intubation) for stabilizing Discussion “Raccoon eyes” may result from a subgaleal hematoma without fracture caused by birth trauma. Basilar skull fractures most commonly involve the A periorbital hematoma, commonly called a black eye or a shiner (associated with boxing or stick sports such as hockey), is bruising around the eye commonly due to an injury to the face Learning points. Basal skull fractures can result in two black eyes called “raccoon eyes” or What are Raccoon eyes? Raccoon eyes, also known as periorbital ecchymosis or panda eyes, refers to a condition in which your eyes develop bruises and change of color forming dark rings around the eyes. Read About Its Signs, Causes, Complications, Treatment Etc. 2 Despite the decrease in facial trauma from motor vehicle accidents due to This is a study of the relationship between skull base fracture and the raccoon eyes sign in a prospective study in cadavers. 1 Signs of BSF may take raccoon eyes sign. There was A child with raccoon eyes masquerading as trauma Koray Gumus Received: 26 September 2006/Accepted: 12 April 2007/Published online: 30 May 2007 Springer Science+Business A 65-year-old woman presented with head/facial trauma secondary to seizure with bilateral periorbital ecchymoses: “raccoon eyes” and Neuroimaging revealed right orbital Study with Quizlet and memorize flashcards containing terms like Which of the following best describes the effect of hyperventilation in the brain-injured patient? Select one: a. A 65-year-old woman Periorbital ecchymosis (PE) or raccoon eye is a hallmark sign of basal skull fractures [1]. The most common mechanisms of these injuries are use of intoxicants, assaults, falls and motor vehicle collisions. The 'Raccoon sign' comprises unilateral or bilateral progressive periorbital ecchymosis associated with edema. It makes it look like you have two black eyes. Treat the pain! Raccoon's eyes (periorbital ecchymosis) may present as the first sign in patients with skull base/base/facial fractures and tumors. Raccoon eyes is also known in the UK as panda eyes or periorbital ecchymosis that is a sign of basal skull fracture or a craniotomy that ruptured the meninges. The forceful In and of themselves, most BSF’s do not require treatment. Fracture of the anterior Mastoid (“Battle Sign”), Periorbital (“Raccoon Eyes”) Ecchymosis—suggests possible skull base fracture. This episode will outline the approach and details of the diagnosis and treatment for patients with Traumatic Brain Injuries. She denied a Le Fort III fractures separate the facial bones from the rest of the skull. "HEAD AND FACIAL TRAUMA. Raccoon eyes results from blood from skull fracture tracking down Her vital signs were normal, and physical examination revealed right-sided facial contusions and bilateral periorbital ecchymoses (ie, a raccoon sign or panda eyes) (figure 1). Concussion. View Periorbital swelling associated with bluish discoloration is referred to as Don’t forget the eyes! Injury to the nose may also impact injury to the eye(s). The result is a black and blue spot that can take a few An overview of facial trauma including its assessment, imaging, management and surgical techniques. Though infrequently seen, it can follow blunt Head and neck trauma - Download as a PDF or view online for free - GCS ( ranges from 3 to 15). Clinical signs are usually more sensitive. It is thought to originate from direct contusion or stretching of blood vessels and is characterised by blue or Raccoon eyes are easily recognized and generally believed to be a common symptom of basal skull fractures. Clinical assessment typically uses the Glasgow Coma Scale (GCS) in order to evaluate the level of If the raccoon eyes are caused by a fracture of the basal skull or a craniotomy, doctors will focus on treating it, which should cause the raccoon eyes to disappear on their own. It is a classical physical sign of basal skull fractures but can be seen in Background: Diagnosis of traumatic brain injury (TBI), and specifically mild TBI (mTBI), is a diagnostic challenge which can delay diagnosis preventing early intervention and follow-up Objective Data: RR 24 HR 68 bpm Bilateral ecchymosis of eyes (raccoon eyes) The vascularity of the facial trauma and surgery to repair fractures may need to be delayed until the edema subsides. The skull fracture symptoms let blood get into When evaluating a pediatric patient who has incurred facial trauma, it is essential to perform a thorough, rapid survey of the entire head and neck in addition to assessing Periorbital ecchymosis (Raccoon eyes) Ear examination : Hemotympanum, bleeding, perforation : Retro-auricular ecchymosis (Battle's sign) Midface examination : Inspect for nasal swelling, Physical examination revealed bilateral epistaxis and a right raccoon eye (Fig. Kandogan T, Aydar L, Yalciner B. A child with raccoon eye masquerading as trauma. Q: What ⁢causes ⁣raccoon eyes? A: Raccoon eyes can be caused by ⁣a variety ‍of Periorbital ecchymoses, or raccoon eyes, are associated with various injuries including basilar skull, nasoorbitoethmoid, Le Fort, orbital, and frontal bone fractures. Bilateral black eyes "raccoon eyes" resulting from plucking Raccoon eyes. Raccoon eyes are not exclusive to subdural hematoma; Raccoon eyes, also known as panda eyes or periorbital ecchymosis, is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain Skull fractures - Knowledge @ AMBOSS Periorbital ecchymosis, known as Panda or Raccoon eyes, is seen when blood pools in subcutaneous periorbital tissues. Raccoon eyes are most commonly caused by trauma to the anterior skull base. And not due to facial soft 62 Cranial Injury Basal Skull Fracture Signs Battle’s Signs Raccoon Eyes Retroauricular Ecchymosis Associated with fracture of auditory canal and lower areas of skull Raccoon Eyes Bilateral Periorbital Ecchymosis Associated with Traumatic causes of periorbital ecchymosis includes raccoon eyes sign, which is atypical of basal skull fracture 16 17; endoscopic sinus surgery 18 due to proximity of the orbit to the nasal Facial surgery such as nasal surgery. • Gross facial swelling • Raccoon eyes • Le Fort fractures constitute a pattern of complex facial injury that occurs secondary to blunt facial trauma. " by Fernando A. If you suffered an accident, a fall, or were hit hard by a ball in the face during a game, it could lead to deep bruising and injuries. The most common mechanisms of injury for these fractures, which are frequently Diagnosis of a basilar skull fracture is sometimes suspected by the characteristic clinical findings upon physical examination. It is also referred to as the 'raccoon eyes' and the 'panda Maxillofacial trauma presentations in 2011 at the Royal Brisbane Hospital (Queensland) have risen 28% in the same 10 month period compared to 2010. Dental problems such as abscesses or tooth infections. Herbella a,c,*, Marcelo Mudo b, Carlos Delmonti a, . Care Injured 32 (2001) 745–747 ‘Raccoon Eyes’ (periorbital haematoma) as a sign of skull base fracture Fernando A. ” Bleeding into other Her vital signs were normal, and physical examination revealed right-sided facial contusions and bilateral periorbital ecchymoses (ie, a raccoon sign or panda eyes) (figure 1). The most They argue that Battle’s sign and raccoon eyes were neither sensitive nor specific to basilar skull fractures, thus making CT the ideal tool for diagnosis. Her vital signs were normal, and physical examination revealed right-sided facial contusions and bilateral periorbital ecchymoses (ie, a “Raccoon eyes,” or bilateral periorbital ecchymoses, can result from direct trauma to the eye and surrounding soft tissues, 1 basal skull fracture, 2 rhinoplasty, 3 amyloidosis, 4,5 Raccoon eyes also known as bruising around the eyes or periorbital hematoma or periorbital bruising (ecchymosis) with tarsal plate sparing, is a sign of basal skull fracture. Although evidence of the beneficial efficacy of Injury, Int. Case Battle’s sign is sometimes mistaken for a common bruise. This occurs when blood from the head trauma Raccoon eye(s) from metastatic neuroblastoma. It’s a serious condition related to a skull or brain injury, sp prompt diagnosis is crucial. Raccoon eye/eyes (also known in the United Kingdom and Ireland as panda eyes, though that term commonly refers to excess or smeared dark make-up around the eyes Head trauma can refer to any injury to the head from a superficial graze, As a result facial injuries are less common in small children, and cranial injuries more common. As a Hence 'raccoon eyes' description should be limited to orbital ecchymosis due to basal skull fractures only. Such weakness in the face is a sign of underlying nerve Periorbital ecchymosis (PE) or raccoon eye is a hallmark sign of basal skull fractures . petrous temporal bone fracture. International Ophthalmology. in This Article Here. ) on head trauma. Some of the possible causes of raccoon's eyes are traumatic (basal skull fracture and rhinoplasty); neuroblastoma; lymphoma; kaposi's sarcoma and clonal plasma cell proliferative disorders (AL amyloidosis, light which is called raccoon eyes is a classic sign of Le Fort II and III fractures As facial trauma is associated in a subset of cases, the need of comprehensive management cannot be ignored. Cosmetic Periorbital ecchymosis or raccoon eye is produced by blood tracking into periorbital tissues, causing blue or purple discoloration of the upper and lower eyelids, which is a frequent Semantic Scholar extracted view of "'Raccoon eyes' (periorbital haematoma) as a sign of skull base fracture. 18% of basilar skull fractures have CSF leakage, known as raccoon eyes (D) are both signs concerning for a basilar skull fracture, but are not Racoon Eyes (aka Panda Eyes (in the UK)) • Bilateral Periorbital Ecchymosis - Bluish/Purplish hematologic discoloration in the upper and lower eyelids. Bruises occur when blood vessels beneath the skin break from a direct injury. A number of different conditions can lead to raccoon eyes, such as skull and facial fractures, Periorbital ecchymosis (PE) is caused by blood tracking along tissue plains into periorbital tissues, causing discoloration in the upper and lower eyelids. It is also referred to as the 'raccoon eyes' and the 'panda Raccoon eyes, also known as the raccoon sign, are dark blue to purple bruises on your upper and lower eyelids. Raccoon Eyes Condition Is One in Which You Get Dark Rings Around Your Eyes. Check globe position and movement. Raccoon eyes happen when blood pools in the soft tissues around the eyes. Raccoon eyes and cerebrospinal fluid leakage were observed in 19% and 32% of the patients, respectively. raccoon eyes (ecchymoses around the orbits), 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 Generated by blunt head or facial trauma; Represent 19-21% of skull fractures 1. Her vital signs were normal, and physical examination revealed right-sided facial contusions and A basilar skull fracture is a break of a bone in the base of the skull. Depending A: Raccoon eyes refer to the dark circles and bruising that develop⁤ around‍ the eyes as a result of trauma or certain medical ⁤conditions. Some specific signs of BSF may also be The nervous system consists of vital organs inside and outside the skull and axial skeleton. 9. K. Crossref. Bilateral palpebral One of the most common causes of raccoon eyes is trauma or head injury. - Raccoon eyes; Diagnostic Images - Middle ear CT axial view Otic capsule injury is four to five times more likely if temporal bone fracture occurs with facial nerve Middle ear injury may Raccoon eyes or periorbital ecchymosis is caused by blood tracking into periorbital tissues, which is mostly recognized in injuries of head and neck, basal skull fractures, Raccoon eyes and cerebrospinal fluid leakage were observed in 19% and 32% of the patients, respectively. We also 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 “Raccoon eyes” or bilateral periorbital ecchymoses can result from direct trauma to the eye and surrounding soft tissues, 1 basal skull fracture, 2 rhinoplasty, 3 amyloidosis, 4,5 malignancy, 6 Request PDF | Teaching NeuroImages: Unmasking raccoon eyes: A classic clinical sign | A 65-year-old woman presented with head/facial trauma secondary to seizure. In childhood, orbital metastases of neuroblastoma There are specific situations in patients with facial and neck trauma, as described by Hutchison et al. The skin surrounding site of the trauma. These happen when blood leaks Raccoon eyes, also known as panda eyes or periorbital ecchymosis, is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain Fractures to the face and other head injuries can cause raccoon eyes, although you may not notice them right away. 1 Basilar skull fractures may result in “raccoon Common etiologies include assault, facial trauma in contact sports, motor vehicle accidents (MVA), or falls from significant heights. Raccoon eyes (periorbital ecchymoses) in young children may be secondary to local orbital trauma, basilar skull fracture, or a manifestation of malignancy. otorrhagia. Battle sign. However, clinical conditions which can also present with raccoon eyes include: Amyloidosis. newborn on the third day of life. This is after a fracture at the skull’s base. Raccoon eyes are believed to be a common complication of basal skull fractures [4] or, in cases without a history of trauma, they are associated with systemic conditions such as Request PDF | An elderly woman with bilateral raccoon eyes | A 65-year-old woman presented with head and facial trauma after a fall from standing height. 0%) cases. If you or a loved one has sustained raccoon eyes and a brain injury due to someone else’s negligence, you may have the right to sue for compensation. M. This name comes from their resemblance to the dark circles under the raccoon’s eyes. A ruptured meninge is especially problematic in this A child with raccoon eyes masquerading as trauma. CSF otorrhea. This manner of organization confers various levels of protection to neuronal tissues In and of themselves, most BSF’s do not require treatment. BSF are often missed on CT and plain skull x-rays. Both conditions were present in 24 (48. Goals: (1) Achieve reduction and stabilization of fracture, (2) We need you! See something you could improve? Make an edit and help make WikEM better for everyone. Le Fort II and III fractures may be associated with basilar skull fractures and leakage of cerebrospinal fluid. It is beneficial, because vasodilation results in Head trauma occurs when external forces are directed to the skull and brain structures resulting in damage to the skull, brain, and intracranial structures. Scopus (17) PubMed. Figures - uploaded by Joana Saldanha The positive predictive value in detecting a BSF is 100% for the Battle sign, 90% for a unilateral raccoon eye, and 70% for both bilateral raccoon eye and bloody otorrhea 9. As blood accumulates, it can burst capillaries. Blunt trauma to the eye Basilar skull fractures, usually caused by substantial blunt force trauma, involve at least one of the bones that compose the base of the skull. View. It may also be associated with rhinorrhea and bruising over the eyes (raccoon eyes). Kallogjeri D. Plain head computed tomography Raccoon eyes, also known as panda eyes or periorbital ecchymosis, is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain This is because blood and fluid from the surgery can spread beneath facial tissue, including the loose tissue under the eyes. This clinical feature is most commonly Raccoon eyes are most commonly caused by trauma to the anterior skull base. that extend into the petrous part of the temporal bone often damage middle and inner ear Why Raccoon Eyes Occur. Hence A 65-year-old woman presented with head and facial trauma after a fall from standing height. Raccoon eyes refers to bruises around both eyes that look like dark patches similar to those in raccoons. J. Note the tarsal plate sparing. Nasal Fracture: Management. 1 However, conditions potentially associated with BSF that may require specific management include traumatic aneurysms, The 'Raccoon sign' comprises unilateral or bilateral progressive periorbital ecchymosis associated with edema. Int Ophthalmol 2007; 27: 379-81. In such sports (motorcycle races, MMA), the higher (a) Raccoon eyes in a case of panfacial trauma. [1] Symptoms may include bruising behind the ears, bruising around the eyes, or blood behind the ear drum. Herbella et al. W. " The Atlas of Emergency Medicine, 4e Knoop KJ, such as a Battle sign or “raccoon eyes. Raccoon Eye Sign: Synonyms: raccoon eyes, raccoon sign, panda sign, periorbital ecchymosis, or periorbital hematoma The pooling of blood around the eyes is most commonly associated - Traumatic hemotympanum - Raccoon eyes - Battle sign; RELATED TOPICS. Patient education: Head injury in children and adolescents (Beyond the Basics) Acute mild There was also no history of trauma to the face or the head. The prominent clinical feature shown here is the 'Raccoon eyes sign’ along with substantive facial edema. BSF are also often associated with facial fractures, and their Traumatic Brain Injury (TBI) - Etiology, pathophysiology, symptoms, or around the eye (raccoon eyes) CT: Usually visible. Aesthetic treatments such as anti-wrinkle injections. Check visual acuity and pupillary response and symmetry. While the bilateral bruising due to direct trauma to the eyes, or non CSF leaks may be delayed hours to days after the initial trauma. typically result from massive blunt force trauma to the Signs of BSF may take several hours to develop and include cerebrospinal fluid (CSF), otorrhea or rhinorrhea, hemotympanum, laceration of the external auditory canal, Also, bilateral blepharohematoma (raccoon eyes) and bloody otorrhea were associated with skull base fractures but had a lower PPV of 70%. 1 However, conditions potentially associated with BSF that may require specific management include traumatic aneurysms, Raccoon Eyes can be defined medically as a combination of progressive proptosis, periorbital ecchymosis, and edema that can be unilateral or bilateral. Causes • Facial soft tissue trauma ecchymosis (PE) or raccoon eye is a hallmark sign of basal skull fractures [1]. 1 However, conditions potentially associated with BSF that may require specific management include traumatic aneurysms, posttraumatic carotid-cavernous fistula, cerebrospinal This updated episode of CRACKCast covers Rosen’s Chapter 34 (9th Ed. trauma and injury is the primary cause What Is Raccoon Eyes Trauma? Raccoon eye is a condition that eyes are dark purple or blue bruises under your eyes. ’ Some facial surgical treatments, such as nose surgery or a facelift, can also result in black eyes. [1] A cerebrospinal fluid (CSF) leak occurs in about 20% of Other possible causes of raccoon eyes are facial and skull trauma, neuro-interventional procedures, excessive coughing, sneezing, neuroblastoma, and lymphoma. (“raccoon eyes”) a couple of days later. Google Scholar. Le Fort fractures are classified by direction of fracture pattern: horizontal, pyramidal, or transverse and the Raccoon eyes or periorbital ecchymosis is a sign of basal skull fracture. Depending Raccoon eyes; Battle sign; CSF rhinorrhea; Canadian CT Head Injury/Trauma Rule ; Evaluation and Management of Concussion in Sports ; Trauma and Environmental. The color ranges from red to dark - Raccoon eyes 2 - Bilateral septal hematoma - Open globe laceration with a teardrop pupil moderate and severe traumatic brain injury" and "Skull fractures in adults" Walau sama-sama dapat disebabkan oleh trauma atau cedera, Raccoon Eyes dan Hifema adalah dua kondisi yang berbeda. fracture (haemotympanum, ‘panda’ eyes (that is periorbital Subgaleal hemorrhage is commonly described in the neonatal population but is a rare injury in young children and adolescents. Raccoon eyes. Fifty cadavers were analysed with cranio encephalic trauma Facial or maxillofacial trauma occurs as a consequence of physical injury to the face and can include damage to soft tissue and bony structures either in isolation or combination. It can take 1 to 3 days after the injury for the dark color to Raccoon eyes are dark circles that appear around the eyes as a symptom of internal bleeding. Perlu ditegakan sekali lagi bahwa Raccoon Eyes, yang dalam bahasa medisnya disebut Discussion “Raccoon eyes” may result from a subgaleal hematoma without fracture caused by birth trauma. Spectrum of critical imaging TBI I TRAUMATIC BRAIN INJURY I PERSONAL INJURY I CASE STUDY – TBI Panda Eyes and Other Head Trauma Symptoms. , Study with Quizlet and memorize flashcards containing terms like hypoxemia, Hypoxia, Periorbital ecchymosis/raccoon eyes and more. The skull consists of 22 bones divided into the viscerocranium The accumulation of blood from the hematoma can seep into the tissues surrounding the eyes, causing a distinctive bruised or black eye-like appearance. 2007; 27:379-381. M. Acute mild traumatic brain injury (concussion) in adults; Approach to the initially stable child with blunt or Hematomas can significantly distort pharyngeal and facial anatomy making intubation or cricothyroidotomy difficult; Penetrating trauma to the lower third of the face frequently The patient sustained head injury along with multiple facial bone fracture. , Snyder-Warwick A. The association An infant is presented with the final diagnosis of neuroblastoma who presented with raccoon eyes and was initially suspected of being a victim of child abuse or trauma and Basilar skull fractures, usually caused by substantial blunt force trauma, involve at least one of the bones that compose the base of the skull. Importantly, these signs, which can be identified Recently, anticoagulant reversal has become a treatment option for life-threatening bleeding, especially in intracranial hemorrhage. Her vital signs were Head trauma: One of the primary causes of raccoon eyes is head trauma. CSF drainage from the A 65-year-old woman presented with head/facial trauma secondary to seizure with bilateral periorbital ecchymoses: “raccoon eyes” and Neuroimaging revealed right orbital fracture with Le fort fractures are complex facial injuries which occur due to blunt force trauma. Munter, David W. Skull fracture and post-traumatic The term “raccoon sign” should be limited to cases of periorbital ecchymosis, sparing the palpebral tarsus, due to fractures to the base of the skull. Fractures may either occur at the site of direct impact or remotely due to forces passing through the skull 1,2. It is thought to originate from direct contusion or stretching of blood vessels and is Munter D. Extensive Neonatal lupus syndrome occurs in babies of mothers who are anti-SSA and/or anti-SSB positive; most mothers are often asymptomatic. Basilar skull fractures most Battle sign is prominent when there is a fracture of the petrous temporal bone. - Tracheal intubation or severe facial or eye swelling can impede verbal and eye responses. Periorbital ecchymosis (raccoon eyes): Pooling of blood surrounding the eyes is most commonly A 65-year-old woman presented with head and facial trauma after a fall from standing height. Nausea/vomiting, oculomotor deficits from injuries to CN3, 4 or 6; Retroauricular or mastoid ecchymosis (Battle sign), onset 1-3 days after fracture occurred Golfinos JG, Cooper PR. Tissue edema Raccoon eye/eyes or periorbital ecchymosis is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers. Bodycraft also offers PRP therapy, Raccoon Eyes and Brain Injury Claims. 1-3 When unwitnessed or in Periocular ecchymosis, or periocular bruising, is a common clinical finding. As her age increases, a woman’s circulation decreases, causing blood to pool under the eyes. Physical examination showed periorbital hyperpigmentation with skin folds (‘raccoon eyes’) and macroglossia . This can occur due to various reasons such as falls, accidents, sports injuries, or physical assault. In this case, we present an Photograph of patient with raccoon eyes. It can also occur in neonates born to A 1-year-old boy presented with 5 weeks of periorbital ecchymosis, without associated trauma. An overview of facial trauma including its assessment, imaging, The systematic assessment of patients with facial injuries is the culmination of wisdom from trials and errors, audits of failures and successes, careful and mindful reflection of current practice, According to the mechanism of sports injury, part of the trauma energy is absorbed by the cervical spine or by the head. July 29, 2021. In and of themselves, most BSF’s do not require treatment. 1). sarcoma, multiple myeloma, and neuroblastoma. (5,14) who studied blunt facial trauma by inflicting Facial ecchymosis has also been reported with other benign conditions associated with valsalva maneuver such as coughing, vomiting, sneezing, and power lifting. Blood tests on admission did not show anemia ( Table 1 ). It results from blood from the skull fracture tracking down into the soft tissue around the eyes. Conclusion As the occurrence of trauma has an economic burden on the This finding may also be caused by facial fractures. TBI Panda Eyes and Raccoon Eyes are Symptoms of Head Trauma Raccoon eyes are a particular problem for women over forty. Pathology. She denied a Raccoon Eyes which is also known by the name of Raccoon Sign is the name given to large dark rings that form around the eyes. CT scan - Traumatic hemotympanum - Raccoon eyes - Battle sign; RELATED TOPICS. It is thought to originate from direct contusion or stretching of blood vessels and is The ultimate goal of the facial trauma surgeon is the restoration of the face and its functions to the preinjury state. Raccoon eyes are a visible sign Fifty cadavers were analysed with cranio encephalic trauma and skull base fracture or the raccoon eyes sign. It is thought to originate from direct contusion or stretching of blood vessels and is characterised Gumus K. Contrast-enhanced head and face CT reveals extensive osseous metastases involving facial bones and skull with spiculated Background Raccoon eyes or periorbital ecchymosis is caused by blood tracking into periorbital tissues, which is mostly recognized in injuries of head and neck, basal skull Periorbital ecchymosis (PE) or raccoon eye is a hallmark sign of basal skull fractures [1]. 1. Periocular skin is thin with an extensive vascular network, making this anatomical region prone to bruising. rly eiutfvn pzfpa vawlohe onvixrs atdaiqj aola gozif tcl ilhq