Clinical comparison of ocular and systemic findings in diagnosed cases of abusive and non-abusive head trauma

Clinical Ophthalmology
Linda A MorganDonny W Suh

Abstract

Child abuse is a leading cause of death in infants, which is often associated with abusive head trauma (AHT). The purpose of this retrospective analysis was to identify ocular and systemic findings in confirmed cases of AHT and compare them to a group of non-abusive head trauma (NAHT) patients. A retrospective chart review of 165 patients with accidental and non-accidental trauma admitted between 2013 and 2015 to Children's Hospital and Medical Center in Omaha, NE, USA, was performed. Diagnosis of AHT was made after the analysis of ocular and systemic findings by various subspecialists. The NAHT group consisted of accidental trauma, abusive trauma without significant apparent head involvement on initial evaluation and unconfirmed AHT cases. Of the 165 presenting cases, 30 patients were diagnosed with AHT and 127 were diagnosed with NAHT. Ocular findings in AHT patients were significant for retinal hemorrhages (63%) and vitreous hemorrhages (37%), while NAHT patients had no ocular findings (p<0.001). Neuroimaging revealed subdural hemorrhages (SDHs) in 29 out of 30 AHT patients (97%) and in 27 out of 127 NAHT patients (21%). Seizures were present in 43% of AHT patients (n=13) and only in 8% of NAHT patients (n=10). AHT has stati...Continue Reading

Citations

Jan 19, 2021·International Journal of Pediatrics·Taylor Goldman, Sathyaprasad Burjonrappa
May 1, 2021·Diagnostics·Aniello MaieseVittorio Fineschi
Sep 28, 2020·Seminars in Ultrasound, CT, and MR·Einat Blumfield
Dec 11, 2021·Pediatrics·Stephen C BoosKent P Hymel

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