The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome(AHT/SBS)is complex.Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS,mild disease is less specific.We report...The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome(AHT/SBS)is complex.Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS,mild disease is less specific.We report the ocular and cerebral findings in an 8‑month‑old girl with spastic torticollis who presented following confessed,violent sagittal plane acceleration‑deceleration with impact.Autopsy revealed subdural hemorrhage over the convexities,ischemic brain injury,and preexisting polymicrogyria.Ocular examination showed extensive but unilateral retinal hemorrhage,extending broadly to the ora serrata,with perimacular retinal folds and retinoschisis.The retina of the right globe was entirely normal.The findings in this case,suggest that movement of the globe within the orbit with acceleration‑deceleration,in this case greater on one side due to torticollis,may be the primary factor for severe hemorrhagic retinopathy associated with AHT/SBS.The findings argue against putative global mechanisms,such as intracranial hypertension.展开更多
Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if ...Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child’s welfare.展开更多
文摘The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome(AHT/SBS)is complex.Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS,mild disease is less specific.We report the ocular and cerebral findings in an 8‑month‑old girl with spastic torticollis who presented following confessed,violent sagittal plane acceleration‑deceleration with impact.Autopsy revealed subdural hemorrhage over the convexities,ischemic brain injury,and preexisting polymicrogyria.Ocular examination showed extensive but unilateral retinal hemorrhage,extending broadly to the ora serrata,with perimacular retinal folds and retinoschisis.The retina of the right globe was entirely normal.The findings in this case,suggest that movement of the globe within the orbit with acceleration‑deceleration,in this case greater on one side due to torticollis,may be the primary factor for severe hemorrhagic retinopathy associated with AHT/SBS.The findings argue against putative global mechanisms,such as intracranial hypertension.
文摘Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child’s welfare.
