Retinal Hemorrhage in Abusive Head Trauma

@article{Levin2010RetinalHI,
  title={Retinal Hemorrhage in Abusive Head Trauma},
  author={Alex V Levin},
  journal={Pediatrics},
  year={2010},
  volume={126},
  pages={961 - 970}
}
  • A. Levin
  • Published 1 November 2010
  • Medicine
  • Pediatrics
Retinal hemorrhage is a cardinal manifestation of abusive head trauma. Over the 30 years since the recognition of this association, multiple streams of research, including clinical, postmortem, animal, mechanical, and finite element studies, have created a robust understanding of the clinical features, diagnostic importance, differential diagnosis, and pathophysiology of this finding. The importance of describing the hemorrhages adequately is paramount in ensuring accurate and complete… 
Clinical Image Retinal Hemorrhages with Abusive Head Trauma
Abusive head trauma (AHT) is perpetrated when an infant or young child is shaken violently, resulting in injuries to various intracranial structures, historically called “shaken baby syndrome”.
Retinal Hemorrhages: Abusive Head Trauma or Not?
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This review focuses on the evaluation of children with RH, with emphasis on the differential diagnosis, pathophysiology, and distinguishing features of RHs due to abusive head trauma.
Timely recognition of retinal hemorrhage in pediatric abusive head trauma evaluation.
TLDR
Multivariate analyses revealed that PICU admission, surgical intervention, and seizure activity were significant predictors of delayed examination after controlling for multiple clinical factors and neurosurgical consultation was shown to be protective against a delayed examination.
Neuroimaging of retinal hemorrhage utilizing adjunct orbital susceptibility-weighted imaging
TLDR
The utility of SWI for detecting retinal hemorrhages in abusive head trauma is reviewed, including discussion of diagnostic limitations and future research.
Severe Retinal Hemorrhages with Retinoschisis in Infants are Not Pathognomonic for Abusive Head Trauma
TLDR
Two cases of severe retinal hemorrhages with retinoschisis associated with subdural hemorrhage in a natural disease and with severe cerebral edema in an accidental head injury challenge the dogma that severe retina hemorrhage with retinoic acid are pathognomonic for AHT.
The Eye Examination in the Evaluation of Child Abuse
TLDR
In previously well young children who experience unexpected apparent life-threatening events with no obvious cause, children with head trauma that results in significant intracranial hemorrhage and brain injury, victims of abusive head trauma, and children with unexplained death, premortem clinical eye examination and postmortem examination of the eyes and orbits may be helpful in detecting abnormalities that can help establish the underlying etiology.
Ophthalmologic Concerns in Abusive Head Trauma
TLDR
The clinical presentation, pathophysiology, natural history, sequelae, and differential diagnosis of retinal hemorrhages and other ocular lesions associated with AHT are reviewed.
Retinal hemorrhages: what are we talking about?
  • A. Levin
  • Medicine
    Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • 2014
W eshould be very proud. Since the initial recognition by Guthkelch in 1971 that retinal hemorrhages are a manifestation of repeated acceleration-deceleration abusive injury with or without impact of
Retinal hemorrhages in children: the role of intracranial pressure.
TLDR
Evaluating the role of intracranial pressure (ICP) in the production of retinal hemorrhage in young children found extensive retinal bleeding in very young children is not secondary to isolated elevated ICP.
The Use of Ophthalmic Ultrasonography to Identify Retinal Injuries Associated With Abusive Head Trauma.
TLDR
Ocular point-of-care ultrasonography is a promising tool to investigate abusive head trauma through the identification of traumatic retinoschisis and retinal hemorrhages when pupillary dilatation and direct ophthalmic examination is delayed.
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