Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Ophthalmol. 2006 Aug;142(2):233-40.

Postmortem orbital findings in shaken baby syndrome.

Author information

  • 1Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Abstract

PURPOSE:

To compare postmortem orbital findings in pediatric accidental head injury to Shaken Baby Syndrome (SBS).

DESIGN:

Retrospective study.

METHODS:

SETTING:

Institutional.

STUDY POPULATION:

Thirty-six patients underwent postmortem modified exenteration with sectioning of the orbital contents; 18 victims of SBS and 18 cases of fatal accidental head trauma.

OBSERVATION PROCEDURE:

In all cases of children who died from accidental head trauma, the orbital tissues were separated to expose the optic nerve sheath. Patients with gross evidence of hemorrhage within the sheath were included. All cases of SBS were included. After accidental head injury, exenteration was performed only if optic nerve sheath hemorrhage was suspected on gross examination. All children younger than 18 years old with head injury as primary cause of death were included. SBS is defined as having at least two of the following: (1) typical abnormal findings on neuroimaging, (2) typical skeletal injury, (3) retinal hemorrhages, (4) history of abusive shaking with or without blunt head trauma, or (5) an inadequate history to explain the observed injuries.

MAIN OUTCOME MEASURE:

Presence or absence of orbital hemorrhage.

RESULTS:

Orbital tissue injury is more common in SBS than accidental head trauma without orbital fracture. In addition, optic nerve sheath and optic nerve intradural hemorrhage are also significantly more common in SBS (P < .0001).

CONCLUSIONS:

Our study reports new evidence of injury to orbital tissues in SBS and supports the concept that these finding are due to unique acceleration-deceleration forces of this type of abusive head injury.

PMID:
16876502
DOI:
10.1016/j.ajo.2006.03.038
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center