American Board of Medicolegal Death Investigators (ABMDI) Practice Exam

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What are raccoon eyes indicative of?

Fracturing of the back skull
Fracturing of the internal front skull
Fracturing of the jaw
Fracturing of the cheekbones

The correct answer is: Fracturing of the internal front skull

Raccoon eyes, often characterized by periorbital ecchymosis (bruising around the eyes), are typically indicative of a specific type of injury associated with skull fractures, particularly around the frontal area. This bruising occurs due to the pooling of blood in the soft tissues surrounding the eyes following trauma to the face or head. When there is a fracture in the internal frontal skull, it can disrupt the blood vessels in that region, leading to this distinctive bruising pattern. The presence of raccoon eyes suggests significant head trauma, which can often be associated with other serious injuries, such as brain injury or fractures of the base of the skull. Hence, the indication of an internal front skull fracture is well-established within trauma assessment practices, thus making this choice correct.