Retinal hemorrhage predicts neurologic injury in the shaken baby syndrome
W. S. Wilkinson, D. P. Han, M. D. Rappley and C. L. Owings
W. K. Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor.
Shaken baby syndrome consists of intracranial and intraocular hemorrhage in
the absence of signs of direct trauma in infants who have sustained
whiplash/shaking injuries. We evaluated 14 consecutive cases of presumed
shaken baby syndrome seen at the University of Michigan Hospitals, Ann
Arbor, between August 1983 and March 1988, to determine if the severity of
retinal hemorrhage was predictive of the severity of acute neurologic
injury. The severity of retinal hemorrhage was based on the type and size
of hemorrhage and the extent of fundus involvement. We found a significant
correlation between retinal hemorrhage severity and acute neurologic
findings. Diffuse fundus involvement, vitreous hemorrhage, or large
subhyaloid hemorrhages were associated with more severe acute neurologic
injury.
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