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Retinal haemorrhage in accidental head trauma in childhood
J E Elder1, R G Taylor, G L Klug
1Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Accidental head injuries in children rarely cause retinal hemorrhages. The absence of these hemorrhages in head-injured children suggests abuse may be involved.
Area of Science:
- Pediatric Ophthalmology
- Pediatric Traumatology
- Forensic Medicine
Background:
- Retinal hemorrhages are a concerning finding in pediatric head trauma.
- Distinguishing between accidental injury and abuse is critical in clinical practice.
Purpose of the Study:
- To prospectively investigate the occurrence of retinal hemorrhages in children with accidental head injuries.
- To evaluate the diagnostic significance of retinal hemorrhages in pediatric head trauma cases.
Main Methods:
- Prospective examination of 25 children (aged 1.2–14.5 years) admitted for accidental head injury.
- Ophthalmoscopic assessment for the presence or absence of retinal hemorrhages.
Main Results:
- No retinal hemorrhages were detected in any of the 25 children with accidental head injuries.
- This finding suggests a low incidence of retinal hemorrhages in non-abusive head trauma.
Conclusions:
- Accidental head injuries in children infrequently lead to retinal hemorrhages.
- The presence of retinal hemorrhages in a child with head trauma warrants strong suspicion of non-accidental injury (abuse).
Abstract:
Twenty-five children (age range 1.2-14.5 years) who sustained accidental head injury requiring admission to hospital were prospectively examined for evidence of retinal haemorrhage. In no case were retinal haemorrhages detected. It is suggested that accidental head injury seldom results in retinal haemorrhage and that the finding of retinal haemorrhage in a child with a head injury should prompt suspicion of abuse.