Retinal Hemorrhages in Children Following Fatal Motor Vehicle Crashes

Abstract

To demonstrate the severity of ocular findings in young children who died of injuries due to motor vehicle crashes. Methods: Case series of 10 children younger than 3 years who were fatally injured in motor vehicle crashes between January 1, 1994, and December 31, 2002. All children underwent autopsy that included eye examination. All available medical and autopsy records, pathology slides and photographs, and police and traffic department reports were reviewed for each case. Results: Eight patients had retinal hemorrhages, which extended into the periphery in 13 eyes and were bilateral in 7 patients. Three patients had elevated circular retinal folds. Six patients had hemorrhages below the internal limiting membrane, but no patients had deeper splitting of the retina. Nine patients had optic nerve sheath hemorrhages. Conclusion: The association of extensive, sometimes severe, ocular hemorrhages with fatal accidental trauma, compared with previous reports of accidental trauma with no or few hemorrhages, indicates the severity of injury required to cause hemorrhages of this magnitude.

Rare retinal haemorrhages in translational accidental head trauma in children

“…These severe high-impact head trauma scenarios go along with a major static load applied to the head for more than 200 ms (such as a heavy object falling on to the victim or a car driving over the victim's head). The same holds true for the eight deceased patients with extensive retinal haemorrhages reported by Kivlin et al 13 very recently. Haemorrhages were bilateral in seven patients and extended into the periphery in all patients.…”

Rare retinal haemorrhages in translational accidental head trauma in children

“…These severe high-impact head trauma scenarios go along with a major static load applied to the head for more than 200 ms (such as a heavy object falling on to the victim or a car driving over the victim's head). The same holds true for the eight deceased patients with extensive retinal haemorrhages reported by Kivlin et al 13 very recently. Haemorrhages were bilateral in seven patients and extended into the periphery in all patients.…”

Retinal haemorrhage in abusive head trauma

“…Recently, lesions similar to the traumatic retinoschisis of abusive head injury have been described in infants who sustained severe fatal head crush injury 55–57 . Similar findings were also described in a series of children who died in motor vehicle accidents 58 …”

Retinal Hemorrhages in Children

“…Almost all the children died. 52,55,56 Severe and sometimes repetitive (eg, motor vehicle rollovers) acceleration-deceleration seen in some motor vehicle collisions are consistent with AHT mechanisms. A hyperacute extreme abrupt increase in ICP may also play a role in RH development.…”

Rare retinal haemorrhages in translational accidental head trauma in children

“…These severe high-impact head trauma scenarios go along with a major static load applied to the head for more than 200 ms (such as a heavy object falling on to the victim or a car driving over the victim's head). The same holds true for the eight deceased patients with extensive retinal haemorrhages reported by Kivlin et al 13 very recently. Haemorrhages were bilateral in seven patients and extended into the periphery in all patients.…”

Retinal haemorrhage in abusive head trauma

“…Recently, lesions similar to the traumatic retinoschisis of abusive head injury have been described in infants who sustained severe fatal head crush injury 55–57 . Similar findings were also described in a series of children who died in motor vehicle accidents 58 …”

Retinal Hemorrhages in Children

“…Almost all the children died. 52,55,56 Severe and sometimes repetitive (eg, motor vehicle rollovers) acceleration-deceleration seen in some motor vehicle collisions are consistent with AHT mechanisms. A hyperacute extreme abrupt increase in ICP may also play a role in RH development.…”

Rare retinal haemorrhages in translational accidental head trauma in children

“…These severe high-impact head trauma scenarios go along with a major static load applied to the head for more than 200 ms (such as a heavy object falling on to the victim or a car driving over the victim's head). The same holds true for the eight deceased patients with extensive retinal haemorrhages reported by Kivlin et al 13 very recently. Haemorrhages were bilateral in seven patients and extended into the periphery in all patients.…”

Retinal haemorrhage in abusive head trauma

“…Recently, lesions similar to the traumatic retinoschisis of abusive head injury have been described in infants who sustained severe fatal head crush injury 55–57 . Similar findings were also described in a series of children who died in motor vehicle accidents 58 …”

Retinal Hemorrhages in Children

“…Almost all the children died. 52,55,56 Severe and sometimes repetitive (eg, motor vehicle rollovers) acceleration-deceleration seen in some motor vehicle collisions are consistent with AHT mechanisms. A hyperacute extreme abrupt increase in ICP may also play a role in RH development.…”