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A 65-year-old woman presented with head and facial trauma after a fall from standing height. 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). She denied a headache and orbital pain. Head computed tomography (CT) was performed, but no skull fracture, periorbital haematoma, encephalorrhagia, punched-out lesion or tumour was detected. Laboratory data indicated kidney dysfunction. The patient reported that the non-painful periorbital skin lesion developed over a period of 1–2 years.
Collaborators Drs Yamaguchi, Yamakawa, and Nohara contributed patient management.
Contributors All authors contributed to patient management. RI drafted the initial manuscript. All author contributed to writing the manuscript. All the authors have provided written consent for publication.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.