Are Two Black Eyes Indicative of Abuse?

Courtesy of Godoy Medical Forensics


Two Black Eyes, also known as Raccoon’s eyes, is a sign of a skull fracture and does not necessarily indicate blunt force trauma to the face. Because this type of skull fracture is often missed on radiology studies, a medical expert is needed to review the records and determine the cause of the bruising.

Hypothetical Case

Neighbors call 911 saying there’s a domestic dispute. Police arrive to find George Johnson yelling at his wife, who is lying on the ground near the stairs. He claims she fell and hit her head; she’s not denying it but is crying and the police are unable to get a clear statement from her. Paramedics assess her and find a lump on the back of her head—she’s a little disoriented so they recommend taking her to the emergency department. Police arrive at the ER to take her statement and find she has developed two black eyes. They talk to the staff at the emergency department and find out she has a skull fracture, therefore George is arrested for assaulting his wife.

The district attorney feels confident that there’s clear evidence of GBI/SBI, even though the wife also says he didn’t hit her. Is there definitive evidence of an assault? Not necessarily…

Basilar Skull Fractures

Basilar Skull Fractures are fractures that are located on the lower half of the skull. Damage to the meninges at the time of the impact causes bleeding into the sinuses; the path of least resistance leads the blood to pool around the eyes. This “bilateral periorbital ecchymosis” is called raccoon’s eyes. It is not due to soft tissue injuries near the eyes.

Some critical facts about Raccoon’s eyes that every attorney should know:

  • The bruising may appear within an hour or may take several days to appear.
  • Basilar Skull Fractures are usually hairline fractures and are often missed on both CT scans and xrays.