RACCOON EYES/PERIORBITAL ECCYMOSIS
Raccoon eyes (panda eyes) or periorbital ecchymosis is a sign of basal skull fracture or subgaleal hematoma, acraniotomy that ruptured the meninges . Bilateral hemorrhage occurs when damage at the time of a facial fracture tears the meninges and causes the venous sinuses to bleed into the arachanoid villi and the cranial sinuses. In lay terms, blood from skull fracture seeps into the soft tissue around the eyes. Raccoon eyes may be accompanied by Battle's sign anecchymosis 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 to two hours after the injury.It is recommended that the patient not blow their nose, cough vigorously, or strain to prevent further tearing of the meninges
