Pathology of retinal hemorrhage in abusive head trauma

Wygnanski–Jaffe, Tamara; Morad, Yair; Levin, Alex V.

doi:10.1007/s12024-009-9134-4

Cited by 24 publications

(8 citation statements)

References 54 publications

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“…Two main mechanisms are proposed: The first is venous outflow obstruction in raised intracranial or intravascular pressure; the second is mechanical, commonly referred to as vitreo-retinal traction (Wygnanski-Jaffe et al. 2009 ). Pathological studies indicate that venous stasis and leakage from retinal vessels are a more likely cause of retinal bleeding than vitreo-retinal traction (Emerson et al.…”

Section: Shaken Baby Syndromementioning

confidence: 99%

Mechanics of the brain: perspectives, challenges, and opportunities

Goriely

Geers

Holzapfel

et al. 2015

Biomech Model Mechanobiol

319

250

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The human brain is the continuous subject of extensive investigation aimed at understanding its behavior and function. Despite a clear evidence that mechanical factors play an important role in regulating brain activity, current research efforts focus mainly on the biochemical or electrophysiological activity of the brain. Here, we show that classical mechanical concepts including deformations, stretch, strain, strain rate, pressure, and stress play a crucial role in modulating both brain form and brain function. This opinion piece synthesizes expertise in applied mathematics, solid and fluid mechanics, biomechanics, experimentation, material sciences, neuropathology, and neurosurgery to address today’s open questions at the forefront of neuromechanics. We critically review the current literature and discuss challenges related to neurodevelopment, cerebral edema, lissencephaly, polymicrogyria, hydrocephaly, craniectomy, spinal cord injury, tumor growth, traumatic brain injury, and shaken baby syndrome. The multi-disciplinary analysis of these various phenomena and pathologies presents new opportunities and suggests that mechanical modeling is a central tool to bridge the scales by synthesizing information from the molecular via the cellular and tissue all the way to the organ level.

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Section: Shaken Baby Syndromementioning

confidence: 99%

Mechanics of the brain: perspectives, challenges, and opportunities

Goriely

Geers

Holzapfel

et al. 2015

Biomech Model Mechanobiol

319

250

View full text Add to dashboard Cite

show abstract

“…2 Furthermore, it has been suggested that almost a third of AHT cases are not identified on initial presentation to a health-care professional, especially since external evidence may not be present. 3 Consequently, there is a need for a novel framework that enables these specialists to identify the clinical signs of this injury competently in order to ensure swift action can be taken to safeguard the child.…”

Section: Introductionmentioning

confidence: 99%

Are we looking for retinal haemorrhages?

Iyer

Lemos

2019

Med Sci Law

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“…Along with damages such as subdural hematomas or diffuse axonal injuries, SBS/AHT is often accompanied by retinal hemorrhages (RHs). RHs are empirically regarded as an important symptom to distinguish abuse from accident because it is seen in approximately 85% of the victims of SBS/ AHT whereas it is observed under accidental context only with decisive external injuries such as those in fatal motor vehicle accidents (Wygnanski-Jaffe et al, 2009). In contrast to the term SBS, the term AHT does not require shaking as a necessary factor, but shaking is still considered as a very major factor.…”

Section: Introductionmentioning

confidence: 99%

A finite element analysis of the retinal hemorrhages accompanied by shaken baby syndrome/abusive head trauma

Yoshida

Yamazaki

Mizunuma

2014

Journal of Biomechanics

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We aimed to elucidate the mechanism of the retinal hemorrhage (RH) accompanied by shaken baby syndrome or abusive head trauma (SBS/AHT) by analyses using a computational model. We focused on a hypothesis that the vitreoretinal traction due to acceleration and deceleration caused by abusive shaking leads to retinal hemorrhage. A finite element (FE) mechanical model with simple spherical geometry was constructed. When the FE mechanical model was virtually shaken, the intensity of the stress applied to the retinal plane agreed well with the results from an analysis using a physical model made of agar gel. Impacts due to falling events induced more intensive tensile stresses, but with shorter duration, than the shake did. By applying a mathematical theory on tackiness, we propose a hypothesis that the time integration of the stress, in the unit of Pa·s, would be a good predictor of the RH accompanied by SBS/AHT. A single cycle of abusive shake amounted to 101Pa·s of time integration of inflicted stress, while a single impact event amounted to 36Pa·s. This would explain the paradoxical observation that shaking induces RH while RH due to impact events is only seen in a major event such as a fatal motor vehicle accident.

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Pathology of retinal hemorrhage in abusive head trauma

Cited by 24 publications

References 54 publications

Mechanics of the brain: perspectives, challenges, and opportunities

Mechanics of the brain: perspectives, challenges, and opportunities

Are we looking for retinal haemorrhages?

A finite element analysis of the retinal hemorrhages accompanied by shaken baby syndrome/abusive head trauma

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