Panda sign due to severe coughing

Abstract

We present the case of a patient who developed periorbital ecchymosis (panda sign) following an exacerbation of asthma with severe coughing. There was no history of cranial trauma. Investigations for a structural or haematological cause were negative. The panda sign is typically seen following a base of skull fracture, but rarely reported due to severe coughing. © 2013 Royal College of Physicians of Edinburgh.