The importance of optic nerve sheath hemorrhage as a postmortem finding in cases of fatal abusive head trauma: A 13-year study in a tertiary hospital

Puanglumyai, Supot; Lekawanvijit, Suree

doi:10.1016/j.forsciint.2017.04.008

Cited by 7 publications

(10 citation statements)

References 30 publications

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“…Sagittal and oblique reformats were obtained to confirm the presence of ON hemorrhages. Given the unavailability of neuroimaging-based literature regarding the diagnosis of ON hemorrhages in AHT, 3D-SWI were analyzed using as a reference of the neuropathological data from the postmortem literature [10][11][12][13][14][15][16]. Only one reader was chosen to analyze the images.…”

Section: Methodsmentioning

confidence: 99%

Novel in vivo depiction of optic nerves hemorrhages in child abuse: a 3D-SWI pilot study

Zuccoli

2021

Neuroradiology

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Purpose Until now, the diagnosis of optic nerves hemorrhages in abusive head trauma (AHT) has been obtained only in the postmortem setting. The aim of the IRB-approved study was to assess the presence of optic nerves hemorrhages in AHT patients using 3D-SWI. Methods Thirteen children with a final confirmed multidisciplinary diagnosis of AHT underwent coronal and axial 3D-SWI imaging of the orbits. The presence of optic nerve sheath (ONS) hemorrhages was defined by thickening and marked 3D-SWI hypointensity of the ONS, resulting in mass effect upon the CSF space. Optic nerve (ON) hemorrhages were defined by areas of susceptibility artifacts in the ON parenchyma. Superficial siderosis was defined by susceptibility artifact coating the ON. Furthermore, data about post-traumatic deformity of the ONS at the head of the optic nerve were collected. Results The average age of the population was 7.9 ± 5.9 months old. The average GCS was 11.8 ± 4.5. The male to female ratio was 7:6. ONS hemorrhages were identified in 69.2% of cases. Superficial siderosis and ON hemorrhages were identified in 38.5 and 76.9% of cases, respectively. 3D-SWI also depicted traumatic deformity of the ONS at the level of the optic nerve head in 10 cases (76.9%). No statistical correlations were identified between RetCam findings and 3D-SWI findings or GCS and ON hemorrhages. Conclusion This research shows that dedicated MRI with volumetric SWI of the orbits can depict hemorrhages in the ON, ONS, and ONS injury, in AHT victims.

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Section: Methodsmentioning

confidence: 99%

Novel in vivo depiction of optic nerves hemorrhages in child abuse: a 3D-SWI pilot study

Zuccoli

2021

Neuroradiology

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“…Such hemorrhages typically involve the anterior portion of the optic nerve, involving multiple layers but, more frequently, the subdural layer [70] and, in decreasing order of frequency, the epidural, intradural, and subarachnoid layers [69]. The genesis of these hemorrhagic phenomena, according to some authors, can be attributed to the translational-rotational accelerations to which the nerve is subjected to during shaking [71] and the fragility of the bridging veins afferent to the retinal central vein; therefore, an abnormal linear or rotational acceleration of traumatic origin can currently be considered the most accredited etiopathogenic mechanism [72].…”

Section: Other Ocular Findings Compatible With Ahtmentioning

confidence: 99%

“…Subsequently, 123 articles were excluded because they did not meet the inclusion criteria. Finally, 16 articles were included for qualitative analysis [71,78,[87][88][89][90][91][92][93][94][95][96][97][98][99][100] (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Despite two articles [87,88] being written in German, all of the considered papers presented abstracts written in English. From a structural point of view, six of them consist of case reports or case series associated with a brief literature review [71,87,88,[91][92][93]; two articles consist of reviews of the scientific knowledge available at the time of writing [78,98]; one is a technical note of the author [90]; and the seven remaining are original articles, all statistically validated [89,[94][95][96][97]99,100].…”

Section: Study Characteristicsmentioning

confidence: 99%

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New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review

et al. 2023

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(1) Background: Head trauma represents the first cause of death in abused children, but diagnostic knowledge is still limited. The characteristic findings of abusive head trauma (AHT) are retinal hemorrhages (RH) and additional ocular findings, including optic nerve hemorrhages (ONH). However, etiological diagnosis must be cautious. (2) Methods: The Preferred Reporting Items for Systematic Review (PRISMA) standards were employed, and the research focus was the current gold standard in the diagnosis and timing of abusive RH. (3) Results: Sixteen articles were included for qualitative synthesis. The importance of an early instrumental ophthalmological assessment emerged in subjects with a high suspicion of AHT, with attention to the localization, laterality, and morphology of the findings. Sometimes it is possible to observe the fundus even in deceased subjects, but the current techniques of choice consist of Magnetic Resonance Imaging and Computed Tomography, also useful for the timing of the lesion, the autopsy, and the histological investigation, especially if performed with the use of immunohistochemical reactants against erythrocytes, leukocytes, and ischemic nerve cells. (4) Conclusions: The present review has made it possible to build an operational framework for the diagnosis and timing of cases of abusive retinal damage, but further research in the field is needed.

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“…Das kindliche Schütteltrauma geht mit retinalen Einblutungen und Subduralhämatomen nach Brückenvenenverletzungen einher, oft begleitet durch eine ONSD-Erweiterung aufgrund der ICP-Erhöhung. Auch echoreiche Blutansammlungen in den Sehnervscheiden lassen sich in vivo sonografisch und post mortem objektivieren [38].…”

Section: Kindliches Schütteltraumaunclassified

Review: Optikussonografie – ein update 2020

Hansen¹,

Helmke²

2020

Klinische Neurophysiologie

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Die Optikus-Sonografie bildet Papille, Sehnerv sowie dessen perineuralenLiquorraum ab und eröffnet damit u. a. einen diagnostischen Zugang zumintrakraniellen Liquorsystem und dessen Druck(ICP). Auf diese Weise lässt sich eine relevante ICP-Erhöhung über 20 mmHg nicht-invasiv und bettseitig belegen. Mit Einzelmessungen und Verlaufskontrollen hilft die Methode u. a. vor und nach der Etablierung eines invasiven ICP-Monitorings in der Intensiv- und Notfallmedizin sowie bei der Beurteilung chronischer Dysregulationen des ICP.

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The importance of optic nerve sheath hemorrhage as a postmortem finding in cases of fatal abusive head trauma: A 13-year study in a tertiary hospital

Cited by 7 publications

References 30 publications

Novel in vivo depiction of optic nerves hemorrhages in child abuse: a 3D-SWI pilot study

Novel in vivo depiction of optic nerves hemorrhages in child abuse: a 3D-SWI pilot study

New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review

Review: Optikussonografie – ein update 2020

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