Supported in part by The Foerderer Fund.
Retinal haemorrhage in abusive head trauma
Article first published online: 15 MAR 2010
© 2010 The Authors. Journal compilation © 2010 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 38, Issue 5, pages 514–520, July 2010
How to Cite
Morad, Y., Wygnansky-Jaffe, T. and Levin, A. V. (2010), Retinal haemorrhage in abusive head trauma. Clinical & Experimental Ophthalmology, 38: 514–520. doi: 10.1111/j.1442-9071.2010.02291.x
- Issue published online: 6 JUL 2010
- Article first published online: 15 MAR 2010
- Received 29 October 2009; accepted 13 January 2010.
- child abuse;
- head trauma;
- retinal haemorrhage;
- shaken baby syndrome
Paediatric abusive head injury may have grave consequences, especially when characterized by repetitive acceleration–deceleration forces (shaken baby syndrome). Death occurs in approximately 30% and permanent neurologic damage in up to 80% of the victims. Retinal haemorrhages are a cardinal sign seen in approximately 85% of cases. In most cases haemorrhages are preretinal, intraretinal and subretinal, too numerous to count, and involving the entire retinal surface extending to the ora serrata. Traumatic macular retinoschisis is a lesion with important diagnostic significance. Vitreoretinal traction appears to be the mechanism of haemorrhage and schisis formation along with a possible role of orbital tissue trauma from repetitive acceleration–deceleration forces. Ophthalmologists must carefully document ocular findings. Appropriate autopsy examination should include ocular and orbital tissue removal. Although there is a wide differential diagnosis for retinal haemorrhages, clinical appearance, when considered in the context of systemic and laboratory findings, usually leads to the correct diagnosis.