NCJ Number
243758
Journal
Journal of Forensic Sciences Volume: 58 Issue: 1 Dated: January 2013 Pages: 228-231
Date Published
January 2013
Length
4 pages
Annotation
This study presents two neonates who sustained accidental, severe in utero head injuries and had associated extensive RHs and optic nerve sheath hemorrhages with peripapillary intrascleral hemorrhages.
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 traumahave been considered essentially pathognomonic for abusive head trauma (shaken baby syndrome). The study presents 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. Abstract published by arrangement with John Wiley & Sons.