Differential Diagnosis for Raccoon Eyes due to Fall
- Single most likely diagnosis
- Basilar skull fracture: This is the most likely diagnosis because "raccoon eyes" (periorbital ecchymosis) is a classic sign of a basilar skull fracture, which can occur due to a fall. The ecchymosis is caused by blood tracking from the posterior orbit into the soft tissues around the eyes.
- Other Likely diagnoses
- Facial fracture: A fall can also cause facial fractures, which may result in periorbital ecchymosis. However, the presence of "raccoon eyes" specifically suggests a basilar skull fracture.
- Orbital fracture: An orbital fracture can also cause periorbital ecchymosis, but it is less likely to be associated with a fall that causes "raccoon eyes".
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intracranial hemorrhage: Although less likely, a fall that causes "raccoon eyes" could also be associated with an intracranial hemorrhage, which is a life-threatening condition that requires prompt diagnosis and treatment.
- Cerebral vasospasm: This is a rare but potentially life-threatening complication of head trauma, which could be associated with a fall that causes "raccoon eyes".
- Rare diagnoses
- Le Fort fracture: This is a type of facial fracture that can cause periorbital ecchymosis, but it is less common and less likely to be associated with "raccoon eyes" due to a fall.
- Neuroblastoma: This is a rare pediatric tumor that can cause periorbital ecchymosis, but it is unlikely to be associated with a fall that causes "raccoon eyes".