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Spontaneous subhyaloid and retinal haemorrhages in an infant

N J McLellan, R Prasad, J Punt

    Archives of Disease in Childhood
    |November 1, 1986
    PubMed

    Insights

    A ruptured brain artery caused seizures and bleeding in a 6-week-old infant. This rare condition, an intracerebral arterial aneurysm, mimicked shaken baby syndrome but had a different cause.

    Area of Science:

    • Pediatric Neurology
    • Vascular Neurology
    • Neonatal Medicine

    Background:

    • Neonatal seizures require prompt diagnosis.
    • Intracerebral arterial aneurysms are rare in infants.
    • Differentiating traumatic from non-traumatic causes of intracranial hemorrhage is critical.

    Observation:

    • A 6-week-old infant presented with seizures.
    • Clinical examination revealed a full fontanelle, retinal hemorrhages, subhyaloid hemorrhages, and anemia.
    • The infant's family was socially isolated.

    Findings:

    • The infant's presentation was not due to abusive head trauma (shaken baby syndrome).
    • Diagnostic imaging revealed a ruptured intracerebral arterial aneurysm as the cause.
    • The combination of seizures and hemorrhages in this context pointed to a vascular event.

    Implications:

    • This case highlights the importance of considering non-accidental vascular causes in neonatal intracranial hemorrhage.
    • Early diagnosis of intracerebral arterial aneurysms is crucial for appropriate management.
    • Social isolation may delay recognition of non-accidental injury, underscoring the need for comprehensive evaluation.

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