B Poepel1, V Seiberth, M C Knorz, W Kachel. 1. Augenklinik, Klinikum Mannheim, Fakultät für Klinische Medizin, Ruprecht-Karls-Universität Heidelberg, Mannheim.
Abstract
UNLABELLED: Violent shaking is a type of child abuse which may cause intracranial hemorrhages combined with retinal and vitreous bleeding. Fundus bleeding is similar to that in Terson syndrome. However, in the shaken baby syndrome the intraocular hemorrhages may precede both the clinical and radiologic recognition of subdural haematoma. CASE REPORT: We present a 4-months-old baby with convulsions and additional extensive bleeding of the fundus. Neither the ocular findings nor the seizures could be explained by minimal lesions of external trauma. Repeated cranial computed tomography showed increasing intracerebral bleeding with consecutive brain atrophy. Fundus bleeding completely disappeared. CONCLUSION: When child abuse is suspected, ophthalmological examination is most important to detect fundus bleeding, which, in the absence of birth trauma or any other supportive evidence of external trauma or other diseases, is the leading symptom of the shaken baby syndrome.
UNLABELLED: Violent shaking is a type of child abuse which may cause intracranial hemorrhages combined with retinal and vitreous bleeding. Fundus bleeding is similar to that in Terson syndrome. However, in the shaken baby syndrome the intraocular hemorrhages may precede both the clinical and radiologic recognition of subdural haematoma. CASE REPORT: We present a 4-months-old baby with convulsions and additional extensive bleeding of the fundus. Neither the ocular findings nor the seizures could be explained by minimal lesions of external trauma. Repeated cranial computed tomography showed increasing intracerebral bleeding with consecutive brain atrophy. Fundus bleeding completely disappeared. CONCLUSION: When child abuse is suspected, ophthalmological examination is most important to detect fundus bleeding, which, in the absence of birth trauma or any other supportive evidence of external trauma or other diseases, is the leading symptom of the shaken baby syndrome.