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Retinal folds and retinoschisis in accidental and non-accidental head injury
1Department of Ophthalmology, University Hospital of Wales, Cardiff, Wales, UK. patrick.watts@cardiffandvale.wales.nhs.uk
Insights
Retinal findings in infants with accidental head injury and non-accidental head trauma show striking similarities. This suggests that specific retinal signs may not exclusively indicate non-accidental head injury in infants.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Forensic Medicine
Background:
- Head injuries in infants can result from both accidental and non-accidental causes.
- Distinguishing between accidental and non-accidental head trauma is critical for appropriate medical and legal interventions.
Observation:
- Two male infants with skull fractures were analyzed.
- Case 1 involved accidental head injury; Case 2 involved non-accidental head injury.
Findings:
- Both infants exhibited significant retinal hemorrhages and optic disc edema.
- Case 1 presented with multiple retinal hemorrhages, optic disc edema, retinal folds, and schitic cavities.
- Case 2 showed optic disc hemorrhage and edema, extensive retinal hemorrhages, and hemorrhagic retinoschisis with a retinal fold.
Implications:
- The ophthalmic findings in both accidental and non-accidental head injuries were remarkably similar.
- This similarity challenges the notion that specific retinal signs are exclusive to non-accidental head injury.
- Further research is needed to understand the spectrum of retinal findings in pediatric head trauma.
Aims:
To report the similarity of retinal findings in an infant who sustained an accidental head injury and an infant with non-accidental head trauma.
Methods:
Two male infants sustained head injuries with skull fractures. Case 1 was an accidental head injury and case 2 was a non-accidental head injury.
Results:
On examination, in case 1, there were four superficial retinal haemorrhages in the right fundus. The left eye had a haemorrhagic optic disc oedema with extensive retinal haemorrhages, retinal folds, and schitic cavities within the retina at the posterior pole. In case 2, the right fundus had a single blot haemorrhage at the posterior pole. The left fundus revealed optic disc haemorrhage and oedema with extensive retinal haemorrhages. There was a haemorrhagic retinoschisis with a retinal fold.
Conclusions:
The two cases, one with accidental and the other with non-accidental injury, demonstrate very similar ophthalmic findings. This supports the argument that there may be no retinal signs seen exclusively in non-accidental head injury.
