Severe cough and retinal hemorrhage in infants and young children

Goldman, Michael; Dagan, Zahi; Mordish, Yair; Elbaz, Uriel; Lahat, Eli; Yair, Morad

doi:10.1016/j.jpeds.2005.12.052

Cited by 38 publications

(20 citation statements)

References 7 publications

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“…Retinal hemorrhages following seizures are extremely rare, with an incidence across four studies of less than 0.1%, in which only one case had unilateral flame-shaped superficial retinal hemorrhages located just at the optic disc and nowhere else [29][30][31][32]. While valsalva retinopathy characterized by preretinal or vitreous hemorrhage (not intraretinal retinal hemorrhage) is a well-described entity in adults, excessive coughing has not been found to cause retinal hemorrhage in young children [33].…”

Section: Differential Diagnosismentioning

confidence: 98%

The eye in child abuse: Key points on retinal hemorrhages and abusive head trauma

Binenbaum

Forbes

2014

Pediatr Radiol

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This review presents an up-to-date overview of ocular injuries resulting from child abuse, with a spotlight on abusive head trauma. Retinal hemorrhage is a principle finding of inflicted head trauma. The specific pattern of hemorrhages holds valuable diagnostic information, which can help to guide multidisciplinary assessments of the likelihood of abuse. Indirect ophthalmoscopy through dilated pupils by an ophthalmologist is necessary for adequate examination and documentation of retinal findings. Initial pediatrician evaluation of the eye and indications for ophthalmological consultation are reviewed. Focus is then placed upon understanding retinal hemorrhage patterns, their diagnostic significance and likely pathophysiological mechanisms. The differential diagnosis of retinal hemorrhage in young children is discussed, highlighting key distinctions among retinal hemorrhage patterns, severity and frequencies, as well as other ocular findings. The most common cause of retinal hemorrhage in an infant is trauma, and most other causes can be identified by considering the hemorrhage pattern, ocular or systemic signs and the results of laboratory and imaging tests, when indicated.

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Section: Differential Diagnosismentioning

confidence: 98%

The eye in child abuse: Key points on retinal hemorrhages and abusive head trauma

Binenbaum

Forbes

2014

Pediatr Radiol

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“…Valsalva hemorrhagic retinopathy is generally thought not to occur in children [54,55]; however, there is at least 1 report of retinal hemorrhages in a child who underwent CPR after being admitted for severe dehydration and vomiting, these caused by either the retching and/or CPR [56]. In addition to the difficult intubation and "stormy" anesthetic reported by Duane [13] and in our patient who coughed, 3 cases of VHR have been published after reportedly uneventful general anesthetic administration.…”

Section: Discussionmentioning

confidence: 61%

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

Patane¹,

Krummenacher

Rao

2015

Journal of Clinical Anesthesia

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“…Increased intrathoracic pressure can also be produced by valsalva maneuver during cough, seizure or severe vomiting. However, these events are not associated with retinal hemorrhage in children [57][58][59][60].…”

Section: Differential Diagnosismentioning

confidence: 86%

Pathology of retinal hemorrhage in abusive head trauma

Wygnanski–Jaffe

Morad

Levin

2009

Forensic Sci Med Pathol

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Abusive head injury, characterized by repeated acceleration-deceleration forces, is associated with retinal hemorrhages as demonstrated in many clinical and postmortem studies. The theory that vitreoretinal traction is the major factor in the pathogenesis of retinal hemorrhages is presently the most widely accepted explanation based on different lines of research. Postmortem examination of the eye and orbital structures is essential for recognizing abusive head injury and also for identifying other possible medical conditions which can cause retinal hemorrhage.

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Severe cough and retinal hemorrhage in infants and young children

Cited by 38 publications

References 7 publications

The eye in child abuse: Key points on retinal hemorrhages and abusive head trauma

The eye in child abuse: Key points on retinal hemorrhages and abusive head trauma

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

Pathology of retinal hemorrhage in abusive head trauma

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