What Type of Skull Fracture can Result In Raccoon Eyes

In this pathology mini bite series this time our topic is What Type Of Skull Fracture Can Result In Raccoon Eyes and we try to learn about it in a few paragraphs. These mini pathology bites are inspired by Kristine Krafts, MD.

 

What Type Of Skull Fracture Can Result In Raccoon Eyes

Our current system is CNS – and so far we’ve covered introductory stuff (e.g., how do brain cells respond to injury), increased intracranial pressure, and congenital/developmental abnormalities. Now we’re moving on to CNS trauma, starting with skull fractures.

There are four main types of skull fractures, and you should know a few key things about each one (nicely summarized here).

1. Linear fracture

  • most common
  • straight crack
  • usually not serious

2. Diastatic

  • crosses one or more sutures
  • sutures widen in response to the fracture
  • usually occur in children

3. Depressed

  • bone displaced inward
  • comminuted (bone broken in many pieces)
  • may damage the underlying brain

4. Basal

  • Least common
  • May see CSF drainage from the nose, ear
  • May result in hematomas, especially in two areas: around the eyes and over the mastoid process.

Why would you get blood around the eyes or behind the ear with a basal skull fracture? Because blood can track from the site of the fracture to adjacent tissues. Here’s a little cartoon showing how this works, along with real-life examples.

Result In Raccoon Eyes

 

 

Reference:

  • Kristine Krafts, MD
  • Robbins Pathology 10th Edition page 1249-51

 

 

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