Ocular manifestations of crush head injury in children

Gnanaraj, Lawrence; Gilliland, M. G. F.; Yahya, R R; Rutka, James T.; Drake, James M.; Dirks, Peter B.; Levin, Alex V.

doi:10.1038/sj.eye.6702174

Cited by 48 publications

(24 citation statements)

References 23 publications

(38 reference statements)

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“…11,12,14,15,17,18,47,56,61,64,66 (Vinchon raw data set)13, 16,67 Data set 2: Highly selected case series/studies with o10 subjects each. 3,[5][6][7][48][49][50][51][52][53][54][55][57][58][59][60]62,63,65,68 Data set 3: Both of the above data sets combined.…”

Section: Resultsmentioning

confidence: 99%

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Maguire

Watts

Shaw

et al. 2012

Eye

160

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Aim To report the retinal signs that distinguish abusive head trauma (AHT) from non-abusive head trauma (nAHT). Methods A systematic review of literature, 1950-2009, was conducted with standardised critical appraisal. Inclusion criteria were a strict confirmation of the aetiology, children aged o11 years and details of an examination conducted by an ophthalmologist. Post mortem data, organic disease of eye, and inadequate examinations were excluded. A multivariate logistic regression analysis was conducted to determine odds ratios (OR) and probabilities for AHT. Results Of the 62 included studies, 13 provided prevalence data (998 children, 504 AHT). Overall, retinal haemorrhages (RH) were found in 78% of AHT vs 5% of nAHT. In a child with head trauma and RH, the OR that this is AHT is 14.7 (95% confidence intervals 6.39, 33.62) and the probability of abuse is 91%. Where recorded, RH were bilateral in 83% of AHT compared with 8.3% in nAHT. RH were numerous in AHT, and few in nAHT located in the posterior pole, with only 10% extending to periphery. True prevalence of additional features, for example, retinal folds, could not be determined. Conclusions Our systematic review confirms that although certain patterns of RH were far commoner in AHT, namely large numbers of RH in both the eyes, present in all layers of the retina, and extension into the periphery, there was no retinal sign that was unique to abusive injury. RH are rare in accidental trauma and, when present, are predominantly unilateral, few in number and in the posterior pole.

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Section: Resultsmentioning

confidence: 99%

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Maguire

Watts

Shaw

et al. 2012

Eye

160

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“…RH, rarely described in non-abusive head trauma (nAHT), is a cardinal manifestation of AHT: it occurs in 85% of cases of AHT, and its severity correlates with the severity of brain injury (25). The forces of a shaking episode may cause the layers of the retina to slide across each other, creating stretching and shearing of the retinal vessels, with hemorrhages (26).…”

Section: Retinal Hemorrhagementioning

confidence: 99%

“…Typically, RHs associated with AHT are multiple, bilateral, confluent, multilayered (involving both preretinal and intraretinal layers), and extended from the posterior pole to the far retinal periphery (27). Moreover, the presence of retinoschisis and retinal folds in an infant with brain injury may be diagnostic of shaking (25). In contrast, RHs described in children with accidental head trauma are rare, more often few in number, and unilateral, involving only the retinal layer and located at the posterior pole (25,28).…”

Section: Retinal Hemorrhagementioning

confidence: 99%

The First Cause of Traumatic Death in Children < 1 Year: A Review on Abusive Head Trauma

et al. 2016

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Context: Pediatric abusive head trauma (AHT) can be defined as an injury to the skull or intracranial contents of a child under the age of 5 due to inflicted blunt impact or violent shaking. Evidence Acquisition: AHT is the most common cause of traumatic death in children younger than 1 year, and it is the leading cause of death due to child abuse. Clinical presentation observed in children with AHT depends on the type of AHT and accompanying injuries. History and physical examination are important for diagnosing AHT and for distinguishing it from other conditions that can mimic shaken baby syndrome, such as accidental trauma, cancer, metabolic diseases, and others. Results: Progress in research on the medical diagnosis of AHT has been remarkable, while the development of treatment strategies has been limited. For these reasons, there is an urgent need to develop effective treatment strategies for AHT able to improve the outcomes. Conclusions:The construction of a nationwide database that supports clinical studies is required in the future.

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“…Retinal haemorrhages almost always require severe life-threatening impact injury. [3][4][5][6][7][8][9][10][11][12][13] They are often relatively mild, isolated to the posterior pole and unilateral.…”

Section: Introductionmentioning

confidence: 99%

Rare retinal haemorrhages in translational accidental head trauma in children

Sturm

Knecht

Landau

et al. 2008

Eye

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Ocular manifestations of crush head injury in children

Abstract: Aims To review the ocular manifestations of crush head injuries in children.

Cited by 48 publications

References 23 publications

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

The First Cause of Traumatic Death in Children < 1 Year: A Review on Abusive Head Trauma

Rare retinal haemorrhages in translational accidental head trauma in children

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