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Retinal haemorrhage

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

  • Not all children were examined for this feature 1-13
  • In a child aged less than three years with intracranial injury and retinal haemorrhage, meta-analysis 14 showed that the positive predictive value for abusive head trauma is 71% (95% confidence interval (CI) 48%-87%) and odds ratio 3.5 (95% CI 1.1 -11.3, p=0.03) 1-13
  • This meta-analysis is based on the presence or absence of retinal haemorrhage without details of the retinal findings

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References

  1. Bechtel K, Stoessel K, Leventhal JM, Ogle E, Teague B, Lavietes S, Banyas B, Allen K, Dziura J, Duncan C. Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics. 2004;114(1):165-168 [Pubmed]
  2. Ewing-Cobbs L, Kramer L, Prasad M, Canales DN, Louis PT, Fletcher JM, Vollero H, Landry SH, Cheung K. Neuroimaging, physical, and developmental findings after inflicted and noninflicted traumatic brain injury in young children. Pediatrics 1998;102(2 Pt 1):300-307 [Pubmed]
  3. Fung EL, Sung RY, Nelson EA, Poon WS. Unexplained subdural hematoma in young children: is it always child abuse? Pediatrics International 2002;44(1):37-42 [Pubmed]
  4. Hettler J, Greenes DS. Can the initial history predict whether a child with a head injury has been abused? Pediatrics 2003;111(3):602-607 [Pubmed]
  5. Hobbs C, Childs AM, Wynne J, Livingston J, Seal A. Subdural haematoma and effusion in infancy: an epidemiological study. Archives of Disease in Childhood. 2005;90(9):952-955 [Pubmed]
  6. Hoskote A, Richards P, Anslow P, McShane T. Subdural haematoma and non-accidental head injury in children. Child's Nervous System. 2002;18(6-7):311-317 [Pubmed]
  7. Keenan HT, Runyan DK, Marshall SW, Nocera MA, Merten DF. A population-based comparison of clinical and outcome characteristics of young children with serious inflicted and noninflicted traumatic brain injury. Pediatrics. 2004;114(3):633-639 [Pubmed]
  8. Kemp AM, Stoodley N, Cobley C, Coles L, Kemp KW. Apnoea and brain swelling in non-accidental head injury. Archives of Disease in Childhood. 2003;88(6):472-476, discussion 476 [Pubmed]
  9. Pierre-Kahn V, Roche O, Dureau P, Uteza Y, Renier D, Pierre-Kahn A, Dufier JL. Ophthalmologic findings in suspected child abuse victims with subdural hematomas. Ophthalmology. 2003;110(9):1718-1723 [Pubmed]
  10. Ruppel RA, Kochanek PM, Adelson PD, Rose ME, Wisniewski SR, Bell MJ, Clark RS, Marion DW, Graham SH. Excitatory amino acid concentrations in ventricular cerebrospinal fluid after severe traumatic brain injury in infants and children: the role of child abuse. Journal of Pediatrics 2001;138(1):18-25 [Pubmed]
  11. Shugerman RP, Paez A, Grossman DC, Feldman KW, Grady MS. Epidural hemorrhage: is it abuse? Pediatrics. 1996;97(5):664-648 [Pubmed]
  12. Tzioumi D, Oates RK. Subdural hematomas in children under 2 years. Accidental or inflicted? A 10-year experience. Child Abuse and Neglect. 1998;22(11):1105-1112 [Pubmed]
  13. Vinchon M, Defoort-Dhellemmes S, Desurmont M, Dhellemmes P. Accidental and nonaccidental head injuries in infants: a prospective study. Journal of Neurosurgery. 2005;102(4 Suppl):380-384 [Pubmed]
  14. Maguire SM, Pickerd N, Farewell D, Mann MK, Tempest V, Kemp AM. Which clinical features distinguish inflicted from non-inflicted brain injury? A systematic review. Archives of Disease in Childhood. 2009;94(11):860-867 [Pubmed]

 

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