There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Timing of Periorbital and Mastoid Ecchymoses
- The exact timing of when periorbital ecchymoses (raccoon eyes) and mastoid ecchymoses (battle signs) typically appear after a basal skull fracture is not explicitly stated in the provided studies 1, 2, 3, 4, 5.
- However, it is mentioned that these signs can be associated with basal skull fractures, and their presence should alert clinicians to assess for skull fractures, intracranial hemorrhage, and cranial nerve injury 2.
- One study notes that the clinical signs for the diagnosis of basilar skull fracture, including raccoon eyes and Battle's sign, have low accuracy and specificity, but their presence is correlated with head injury severity 4.
- Another study describes a case where a patient presented with bilateral periorbital hematoma (raccoon eyes) and bilateral retroauricular ecchymosis after a fall, which were indicative of a basilar skull fracture 5.
- There is no specific information provided on the typical timeframe for the appearance of these signs after a basal skull fracture, suggesting that further research may be needed to determine this information.