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Are peripapillary intrascleral hemorrhages pathognomonic for abusive head trauma?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Schoppe, Candace H. Lantz, Patrick E.
Description	Country affiliation: United States Author Affiliation: Schoppe CH ( Office of Chief Medical Examiner, 520 1st Avenue, New York, NY 10016, USA. CSchoppe@ocme.nyc.edu)
Abstract	The American Academy of Pediatrics' Committee on Child Abuse and Neglect, Section on Ophthalmology, acknowledges that searching for retinal hemorrhages (RHs) in infants only in cases of suspected of abuse creates selection bias. However, they also recommend that postmortem eye removal might not be indicated 'in children who have clearly died from witnessed severe accidental head trauma or otherwise readily diagnosed systemic medical conditions.' Although infrequently described in the child abuse literature, peripapillary intrascleral hemorrhages (bleeding in the sclera at the optic nerve insertion)--putatively from severe repetitive acceleration/deceleration forces with or without blunt head trauma--have been considered essentially pathognomonic for abusive head trauma (shaken baby syndrome). We present two neonates who sustained accidental, severe in utero head injuries and had associated extensive RHs and optic nerve sheath hemorrhages with peripapillary intrascleral hemorrhages detected at autopsy. Neither neonate had a documented clinical fundal examination in the intensive care unit.
File Format	HTM / HTML
ISSN	00221198
Issue Number	1
Volume Number	58
e-ISSN	15564029
Journal	Journal of Forensic Sciences
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2013-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Optic Nerve Diseases Prenatal Injuries Cerebral Hemorrhage Head Injuries, Closed Humans Brain Edema Male Discipline Forensic Sciences Accidents, Traffic Scleral Diseases Journal Article Case Reports Pathology Cesarean Section Eye Hemorrhage Skull Fractures Female Forensic Pathology Infant, Newborn
Content Type	Text
Resource Type	Case study Article
Subject	Genetics Pathology and Forensic Medicine

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