Original articleOphthalmologic findings in suspected child abuse victims with subdural hematomas☆
Section snippets
Patients and methods
This prospective study consisted of 241 consecutive children younger than 3 years of age admitted for SDH in the Pediatric Neurosurgical Department of the Hôpital Necker-Enfants Malades in Paris from January 1996 through September 2001. Caretakers' histories were recorded searching for direct head trauma or shaken neglect. All children underwent a complete physical and neurologic examination, a computed tomography (CT) scan of the head, and systemic x-rays of the skeleton to detect possible
Results
The median age of the 231 patients at admission was 4.6 months (range, 0.8–29 months); 96.5% of the babies were younger than 1 year. In groups 1, 2, and 3, median ages were, respectively, 4.6 months (range, 0.8–29), 5.5 months (range, 1–18), and 1.5 months (range, 0.9–3.9). There were 165 males and 66 females (gender ratio, 5:2). This ratio was the same in the 3 groups.
Discussion
As far as we are aware, this study is the largest prospective study on ophthalmologic clinical abnormalities in shaken infants. SBS is a form of child abuse whose diagnosis is difficult to establish because a history of shaking events is often unreliable. Both direct head trauma and shaking maneuvers can provoke subdural bleeding. Among shaken babies, some show evidence of additional direct head trauma (fractures of the vault, wounds, or bruises of the scalp).4 It therefore becomes difficult
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2022, Pediatric NeurologyTwo Infant Boys Misdiagnosed as “Shaken Baby” and Their Twin Sisters: A Cautionary Tale
2019, Pediatric NeurologyTraumatic macular retinoschisis in infants and children
2018, Journal of AAPOSPhotographic assessment of retinal hemorrhages in infant head injury: the Childhood Hemorrhagic Retinopathy Study
2017, Journal of AAPOSCitation Excerpt :It has also been ascribed to a combination of shaking and impact or, less commonly, severe impact alone.11 The rate of RH in both AHT (78%) and accidental head injuries (5%) in this study is similar to that reported in previous prospective studies of pediatric traumatic brain injury.12-15 The rate of retinoschisis and retinal folds was higher in our cohort of AHT (38%) than previously reported in the literature.4
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Manuscript no. 220518.