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Bilateral periopticointrascleral hemorrhages associated with traumatic child abuse
1Department of Ophthalmology, Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, California 90095-7000, USA.
Insights
Bilateral periopticoscleral hemorrhages were found in an infant with a subdural hematoma. These findings suggest blunt head trauma and are crucial forensic evidence in suspected child abuse cases.
Area of Science:
- Ophthalmology
- Forensic Pathology
- Pediatric Medicine
Background:
- Child abuse is a significant public health concern.
- Ocular findings in abusive head trauma can be subtle.
- Accurate diagnosis is critical for child protection.
Observation:
- A 6-month-old infant presented with a subdural hematoma.
- Postmortem examination revealed bilateral periopticoscleral hemorrhages.
- Additional retinal, vitreous, and sublaminar hemorrhages were noted.
Findings:
- The hemorrhages were located intrasclerally around both optic nerves.
- Histopathology confirmed the presence and extent of the hemorrhages.
- These findings are characteristic of blunt force head trauma.
Implications:
- Periopticointrascleral hemorrhages serve as key forensic evidence.
- Recognition of these hemorrhages aids in diagnosing abusive head trauma.
- This case highlights the importance of ophthalmologic examination in suspected child abuse.
Purpose:
To report a case of bilateral periopticoscleral hemorrhages associated with traumatic child abuse.
Methods:
Postmortem gross examination and histopathologic studies of both eyes and the optic nerves of a 6-month-old infant who died from subdural hematoma.
Results:
Gross examination and histopathologic step sections disclosed bilateral intrascleral hemorrhages around both optic nerves. In addition, bilateral diffuse multilayered retinal, vitreous, and sublaminar (beneath the internal limiting membrane) hemorrhages were present.
Conclusion:
Periopticointrascleral hemorrhages are characteristic of blunt head trauma and may constitute important forensic evidence in cases of suspected child abuse.