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.
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KumarVGhoshBRainaUK Bilateral periorbital ecchymosis in a case with dengue fever. Indian J Ophthalmol 2009; 57: 242–3. http://dx.doi.org/10.4103/0301-4738.49407
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AttanasioAD’AmicoDFredianiF Trigeminal autonomic cephalgia with periorbital ecchymosis, ocular hemorrhage, hypertension and behavioral alterations. Pain 2000; 88:109–12. http://dx.doi.org/10.1016/S0304-3959(00)00308-0
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