Arterial dissection and stroke following child abuse: case report and review of the literature

Agner, Celso; Weig, Spencer G.

doi:10.1007/s00381-004-1056-6

Cited by 20 publications

(15 citation statements)

References 26 publications

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“…8 studies were comparative, including three crosssectional, [11][12][13] two comparative case series, 14,15 one prospective cohort study, 16 one case-control 17 and one retrospective cohort study. 18 The remainder were case reports 5,6,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] or case series, 3,7, concerning AHT alone, 3,[19][20][21][22][23][25][26][27][28][29][30][31][33][34][35][36][37][3...…”

Section: Resultsmentioning

confidence: 99%

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Maguire

Watts

Shaw

et al. 2012

Eye

162

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Aim To report the retinal signs that distinguish abusive head trauma (AHT) from non-abusive head trauma (nAHT). Methods A systematic review of literature, 1950-2009, was conducted with standardised critical appraisal. Inclusion criteria were a strict confirmation of the aetiology, children aged o11 years and details of an examination conducted by an ophthalmologist. Post mortem data, organic disease of eye, and inadequate examinations were excluded. A multivariate logistic regression analysis was conducted to determine odds ratios (OR) and probabilities for AHT. Results Of the 62 included studies, 13 provided prevalence data (998 children, 504 AHT). Overall, retinal haemorrhages (RH) were found in 78% of AHT vs 5% of nAHT. In a child with head trauma and RH, the OR that this is AHT is 14.7 (95% confidence intervals 6.39, 33.62) and the probability of abuse is 91%. Where recorded, RH were bilateral in 83% of AHT compared with 8.3% in nAHT. RH were numerous in AHT, and few in nAHT located in the posterior pole, with only 10% extending to periphery. True prevalence of additional features, for example, retinal folds, could not be determined. Conclusions Our systematic review confirms that although certain patterns of RH were far commoner in AHT, namely large numbers of RH in both the eyes, present in all layers of the retina, and extension into the periphery, there was no retinal sign that was unique to abusive injury. RH are rare in accidental trauma and, when present, are predominantly unilateral, few in number and in the posterior pole.

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Section: Resultsmentioning

confidence: 99%

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Maguire

Watts

Shaw

et al. 2012

Eye

162

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“…We included 19 small case series or case studies, published between 1975 and February 2009, representing 25 children who had sustained inflicted spinal injury 8 11 14–30. All studies ranked 1–2 for abuse, confirmed by communication with authors in two studies 28 30.…”

Section: Resultsmentioning

confidence: 99%

What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review

Kemp

Joshi

Mann

et al. 2009

Archives of Disease in Childhood

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Spinal injury is a potentially devastating inflicted injury in infants and young children. The published evidence base is limited. However, this case series leads us to recommend that any clinical or radiological indication of spinal injury warrants an MRI. In children undergoing brain MRI for abusive head trauma, consideration should be given to including an MRI of the spine. All skeletal surveys in children with suspected abuse should include lateral views of the cervical and thoraco-lumbar spine. Further prospective comparative studies would define the discriminating features of inflicted spinal injuries.

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“…Arterial dissection may be caused by direct trauma to the artery, hyperextension-rotation of the head with stretching of vessels, basal skull or mandibular fractures, chest-head injuries with carotid stretching and blunt intraoral trauma [4][5][6][7]. It has been postulated by other authors [16] that congenital kinking or coiling of the cervical ICA predisposes a patient to trauma-induced dissection.…”

Section: Discussionmentioning

confidence: 96%

“…Arterial dissection may be caused by direct trauma to the artery, hyperextensionrotation of the head with stretching of vessels, basal skull or mandibular fractures, chest-head injuries with carotid stretching and blunt intra-oral trauma [4][5][6][7]. Dissection can be a diagnostic challenge due to the complexity of the clinical examination in small children and a delayed onset of symptoms in many cases [7,8].…”

Section: Introductionmentioning

confidence: 98%

Carotid artery dissection following a minor household accident in a 10-month-old child

et al. 2009

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Arterial dissection and stroke following child abuse: case report and review of the literature

Abstract: Recognition of potential cases of child abuse is crucial. Early intervention and cessation of interaction between the aggressor and the child are important measures to be taken in all situations when there is strong evidence of suggestive examination of child abuse.

Cited by 20 publications

References 26 publications

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review

Carotid artery dissection following a minor household accident in a 10-month-old child

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