| Ophthalmologic findings in suspected child abuse victims with subdural hematomas. | |
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MedLine Citation:
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PMID: 13129868 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Shaken baby syndrome consists of intracranial and intraocular hemorrhages in young children in the absence of signs of direct head trauma. Because it has major medicolegal implications, it must be distinguished from accidental trauma. This study aimed to determine the ophthalmologic manifestations and their natural course in child abuse victims and whether ophthalmologic examination can help to distinguish shaken babies from children with accidental impact head trauma. DESIGN: Prospective comparative observational case series. METHODS: A prospective study was conducted from January 1996 to September 2001 on 241 consecutive infants hospitalized for a subdural hematoma to determine the frequency and the type of ocular abnormalities encountered. At admission, 186 children were highly presumed to have been shaken (group 1), 38 children had signs of direct head trauma without any relevant history of trauma (group 2), some of them having been possibly shaken, whereas 7 children had proven severe accidental head trauma (group 3). RESULTS: Intraocular hemorrhages were the main finding. Their shape, laterality, and size were not significantly different in groups 1 and 2. However they were significantly more frequent in nonaccidental head trauma than in infants with head impact (77.5% versus 20%). None of the group 3 children had intraocular hemorrhage. Eighty-two percent of intraocular hemorrhages resolved within 4 weeks. CONCLUSIONS: Intraocular hemorrhages are frequent in shaken babies but not specific of this syndrome. When associated with a subdural hematoma, they are strongly suggestive of shaken neglect. They are rare in pediatric accidental head trauma. |
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Authors:
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Vincent Pierre-Kahn; Olivier Roche; Pascal Dureau; Yves Uteza; Dominique Renier; Alain Pierre-Kahn; Jean-Louis Dufier |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ophthalmology Volume: 110 ISSN: 0161-6420 ISO Abbreviation: Ophthalmology Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-17 Completed Date: 2003-09-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: United States |
Other Details:
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Languages: eng Pagination: 1718-23 Citation Subset: IM |
Affiliation:
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Department of Ophthalmology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris 5, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Child Abuse
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diagnosis* Child, Preschool Diagnosis, Differential Female Fundus Oculi Hematoma, Subdural / diagnosis*, etiology Humans Infant Male Prospective Studies Retina / pathology Retinal Hemorrhage / diagnosis*, etiology Shaken Baby Syndrome / complications, diagnosis* |
| Comments/Corrections | |
Comment In:
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Ophthalmology. 2004 Sep;111(9):1795-6
[PMID:
15350345
]
Ophthalmology. 2004 Sep;111(9):1794; author reply 1794-5 [PMID: 15350343 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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