Retinal Hemorrhages of Crush Head Injury

Levin, Alex V.

doi:10.1001/archopht.124.12.1773

Cited by 23 publications

(7 citation statements)

References 13 publications

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“…30 It may be that direct ocular shear during crush injury rarely replicates the vitreoretinal traction that characterizes SBS. 31 Results of postmortem studies of SBS victims also support results of the clinical studies. 18,[32][33][34] In 1 study, hemorrhage in orbital tissues was noted, which suggests that globe movement during repeated accelerationdeceleration causes disruption of orbital vessels and tissues.…”

Section: Clinical Studies Of Affected Childrensupporting

confidence: 57%

Retinal Hemorrhage in Abusive Head Trauma

2010

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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 differential diagnosis. Challenges remain in developing models that adequately replicate the forces required to cause retinal hemorrhage in children. Although questions, such as the effect of increased intracranial pressure, hypoxia, and impact, are still raised (particularly in court), clinicians can confidently rely on a large and solid evidence base when assessing the implications of retinal hemorrhage in children with concern of possible child abuse.

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Section: Clinical Studies Of Affected Childrensupporting

confidence: 57%

Retinal Hemorrhage in Abusive Head Trauma

2010

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“…The clinical picture of massive rental haemorrhages, in multiple layers, extending across the fundus, particularly if it is accompanied by a retinoschisis cavity at the macula, is considered to be almost pathognomic of AHT. This appearance has also been recently described in several cases following severe (often fatal) crush head injury so this should be excluded by the history, accompanying signs and forensic examination 11 . There are a number of medical conditions that can cause retinal bleeding and these need to be excluded.…”

mentioning

confidence: 82%

Retinal haemorrhages in infants, abusive head trauma and the ophthalmologist

Gole

2010

Clinical Exper Ophthalmology

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“…The mechanism leading to extensive RH in these unique cases of fatal head crush injuries is unclear. 51 A hyperacute and extreme increase in ICP may play a role. This is different than the subacute ICP elevation in AHT.…”

Section: When Increased Icp Might Cause Rhmentioning

confidence: 99%