Raccoon eyes sign (base of skull fracture)

Raccoon eyes sign (or panda eyes in the UK and Ireland) refers to periorbital ecchymosis with sparing of the tarsal plate  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 .