Vertical sensory nystagmus associated with intraocular haemorrhages in the shaken baby syndrome

Mulvihill, Alan; Buncic, J. Raymond

doi:10.1038/sj.eye.6700704

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…2 Retinal hemorrhages. Various forms of retinal hemorrhage (between arrowheads) in a case of a 10-month-old female infant with a diagnosis of SBS after being admittedly shaken: a subretinal, b intraretinal, c submembranous (still covered by the internal membrana limitans), and d subhyaloid (H&E staining; scale bar 50 μm) [115], keratoconjunctivitis [93], vertical sensory nystagmus [83], giant retinal tears [69], epiretinal membrane formation [27], and traumatic cranial nerve palsy [13,30,65].…”

Section: Ocular Pathology Other Than Rh and Optic Nerve Sheath Hemorrmentioning

confidence: 99%

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

2008

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Retinal and optic nerve sheath hemorrhages are an essential part of the various forms of inflicted neurotrauma in infants, especially in its most common variant, the shaken baby syndrome (SBS). Clinically, ophthalmologists play an important part for the diagnosis and further management of patients with SBS. For the forensic pathologist, a thorough understanding of the basic principles behind the morphological phenomena commonly encountered in the orbita is required. This review summarizes the present knowledge of ocular pathology in inflicted infantile neurotrauma, focusing strongly on SBS. Furthermore, a review of the most recent literature on the subject is given.

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Section: Ocular Pathology Other Than Rh and Optic Nerve Sheath Hemorrmentioning

confidence: 99%

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

2008

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“…Unfortunately, many studies could not be included in the review due either to inadequate multidisciplinary confirmation of abuse, 71 lack of ophthalmological detail, or details of the standard of ophthalmological examination. 72 Clearly an optimal examination, in particular ensuring an adequate view of the periphery, is essential, even though this may be technically challenging in an awake infant.…”

Section: Discussionmentioning

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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“…This was an 8-week-old with shaken baby syndrome associated with a constant, large-amplitude vertical pendular nystagmus of moderate frequency. 5 Nystagmus and saccadic intrusions are differentiated by the type of eye movement that initiates the shift in eye position from fixation. Unlike nystagmus which begins with a slow drift of the eyes called the slow phase, saccadic intrusions are initiated by a fast saccadic eye movement away from fixation.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of the authors’ knowledge, saccadic intrusions and/or nystagmus have only been reported once in literature in association with NAT. 5 This was a case of an 8-week-old with shaken baby syndrome associated with the finding of a constant, large-amplitude vertical pendular nystagmus of moderate frequency.…”

Section: Introductionmentioning

confidence: 99%

Saccadic intrusions in pediatric non-accidental trauma

Dai

Kuwera

2022

American Journal of Ophthalmology Case Reports

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Vertical sensory nystagmus associated with intraocular haemorrhages in the shaken baby syndrome

Cited by 4 publications

References 4 publications

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

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

Saccadic intrusions in pediatric non-accidental trauma

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