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Retinal hemorrhage infants

Babette Bais, Wouter A Karst, Bela Kubat, Robert M Verdijk
Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5-month-old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas, and retinal hemorrhages consistent with abusive head trauma (AHT). At the age of 3, he was readmitted to hospital with spontaneous osteopenic fracture of the right femur. The patient deteriorated and died after unsuccessful resuscitation...
November 2016: Journal of Forensic Sciences
Ann Hellström, David Ley, Ingrid Hansen-Pupp, Boubou Hallberg, Luca A Ramenghi, Chatarina Löfqvist, Lois E H Smith, Anna-Lena Hård
Retinopathy of prematurity is a potentially blinding disease, which is associated with low neonatal IGF-I serum concentrations and poor growth. In severe cases impaired retinal vessel growth is followed by pathologic neovascularization, which may lead to retinal detachment. IGF-I may promote growth even in catabolic states. Treating preterm infants with recombinant human (rh) IGF-I to concentrations normally found during gestation has been suggested to have a preventative effect on ROP. A recent phase 2 study treating infants (gestational age between 23weeks+0days and 27weeks +6days) with rhIGF-I/IGF binding protein-3 until 30 postmenstrual weeks showed no effect on ROP but a 53% reduction in severe bronchopulmonary dysplasia and 44% reduction in severe intraventricular hemorrhage...
September 28, 2016: Growth Hormone & IGF Research
Ann Hellström, David Ley, Ingrid Hansen-Pupp, Boubou Hallberg, Luca A Ramenghi, Chatarina Löfqvist, Lois E H Smith, Anna-Lena Hård
The neonatal period of very preterm infants is often characterized by a difficult adjustment to extrauterine life, with an inadequate nutrient supply and insufficient levels of growth factors, resulting in poor growth and a high morbidity rate. Long-term multisystem complications include cognitive, behavioral, and motor dysfunction as a result of brain damage as well as visual and hearing deficits and metabolic disorders that persist into adulthood. Insulinlike growth factor 1 (IGF-1) is a major regulator of fetal growth and development of most organs especially the central nervous system including the retina...
September 2016: American Journal of Perinatology
Gui-Shuang Ying, Deborah VanderVeen, Ebenezer Daniel, Graham E Quinn, Agnieshka Baumritter
PURPOSE: To develop a risk score for predicting treatment-requiring retinopathy of prematurity (TR-ROP) in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study. DESIGN: Second analyses of an observational cohort study. PARTICIPANTS: Infants with birth weight (BW) <1251 g who had ≥1 imaging session by 34 weeks of postmenstrual age (PMA) and ≥1 subsequent retinopathy of prematurity (ROP) examination for determining TR-ROP by study-certified ophthalmologists...
October 2016: Ophthalmology
Brian S Payne, Timothy J Kutz, Ann Di Maio, James M Gerard
BACKGROUND: Fractures are a frequent reason for emergency department visits and evaluation for abusive head trauma is an associated concern in infants. Recent guidelines have suggested that retinal examination may not be necessary in the absence of intracranial injury, but there is a lack of empirical evidence in infants < 1 year of age. OBJECTIVE: Our aim was to evaluate the prevalence of retinal hemorrhages in infants with isolated long bone fractures. METHODS: Retrospective chart review of infants < 1 year of age who presented to an urban, tertiary care pediatric hospital between January 2004 and April 2014 with the diagnosis of an acute long bone fracture or retinal hemorrhages...
October 2016: Journal of Emergency Medicine
Shunsuke Amagasa, Hikoro Matsui, Satoshi Tsuji, Takashi Moriya, Kosaku Kinoshita
OBJECTIVE: We investigated the accuracy of parental reports of infant trauma history. METHODS: We retrospectively reviewed 166 infants from 3 tertiary institutions in Japan that had suffered a traumatic intracranial hemorrhage between 2002 and 2013. The infants were classified into 3 groups based on the parents' report of the mechanism of injury: the low-risk group consisted of injuries sustained from falling off a height below 3 ft. (n=84); the middle-to-high-risk group comprised other mechanisms of injury (n=54); and the unknown-risk group consisted of unknown mechanisms of injury (n=28)...
September 2016: American Journal of Emergency Medicine
Scott Boop, Mary Axente, Blakely Weatherford, Paul Klimo
OBJECTIVE Research on pediatric abusive head trauma (AHT) has largely focused on clinical presentation and management. The authors sought to review a single-institution experience from a public health perspective to gain a better understanding of the local population affected, determine overall incidence and seasonal trends, and provide details on the initial hospitalization, including extent of injuries, neurosurgical interventions, and hospital charges. METHODS All cases of AHT involving patients who presented to Le Bonheur Children's Hospital (LBCH) from 2009 through 2014 were identified...
July 12, 2016: Journal of Neurosurgery. Pediatrics
Homero Augusto de Miranda, Marcelo Cavalcante Costa, Maria Auxiliadora Monteiro Frazão, Natália Simão, Sandra Franchischini, Darius M Moshfeghi
PURPOSE: To describe the ocular findings of 3 cases of suspected congenital Zika viral infection with microcephaly and maculopathy. DESIGN: Retrospective, consecutive case series. PARTICIPANTS: Three male infants born in northern Brazil whose mothers demonstrated a viral syndrome during the first trimester and who subsequently were born with microcephaly. METHODS: Observational report of macular findings. MAIN OUTCOME MEASURES: Continued observation...
August 2016: Ophthalmology
Matthew A Zapala, Andy Tsai, Paul K Kleinman
BACKGROUND: Growth recovery lines, also known as growth arrest lines, are transverse radiodense metaphyseal bands that develop due to a temporary arrest of endochondral ossification caused by local or systemic insults. OBJECTIVE: To determine if growth recovery lines are more common in infants at high risk versus low risk for abuse. MATERIALS AND METHODS: Reports of American College of Radiology compliant skeletal surveys (1999-2013) were reviewed with clinical records...
August 2016: Pediatric Radiology
W Reith, U Yilmaz, C Kraus
The shaken baby syndrome (SBS) or shaking trauma describes the occurrence of subdural hematoma, retinal hemorrhage and diffuse injury to the brain by vigorous shaking of an infant that has a poor prognosis. Rapid cranial acceleration and deceleration leads to tearing of bridging veins, retinal hemorrhages and diffuse brain injuries. In addition to clinical symptoms, such as irritability, feeding difficulties, somnolence, apathy, seizures, apnea and temperature regulation disorders, vomiting also occurs due to increased intracranial pressure...
May 2016: Der Radiologe
Joshua D Levinson, Melissa A Pasquale, Scott R Lambert
We report a case of diffuse bilateral retinal and optic nerve sheath hemorrhages in an 8-week-old boy who was found unresponsive. The child underwent prolonged cardiopulmonary resuscitation and was noted on admission to have a coagulopathy. An autopsy determined the cause of death to be a myocardial infarct in the distribution of an anomalous coronary artery. This case demonstrates the difficulty that may occur in establishing whether child abuse caused death in the setting of another potential cause of mortality...
April 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Hiroshi Karibe, Motonobu Kameyama, Toshiaki Hayashi, Ayumi Narisawa, Teiji Tominaga
The number of cases with child abuse is increasing in Japan, and abusive head trauma (AHT) is a major cause of death in abused children. Child abuse has been recognized by the late 19th century, and widely accepted as battered child syndrome in the middle of the 20th century. As terms, there had been considerable mechanistic controversies between shaken-baby and -impact syndrome until the beginning of the 21st century. In recent years, AHT has been utilized as a less mechanistic term. Most of the characteristics of AHT in Japan have been similar to those in the United States as follows: infant is the most common victim, acute subdural hematoma (SDH) is the most common intracranial lesion, and retinal hemorrhage is often complicated...
May 15, 2016: Neurologia Medico-chirurgica
Brittany Coats, Gil Binenbaum, Colin Smith, Robert L Peiffer, Cindy W Christian, Ann-Christine Duhaime, Susan S Margulies
Repetitive back-and-forth head rotation due to vigorous shaking is purported to be a central mechanism responsible for diffuse white matter injury, subdural hemorrhage and retinal hemorrhage in some cases of abusive head trauma (AHT) in young children. Although animal studies have identified mechanisms of traumatic brain injury (TBI) associated with single rapid head acceleration-decelerations at levels experienced in a motor vehicle crash, few experimental studies have investigated TBI from repetitive head rotations...
March 7, 2016: Journal of Neurotrauma
Natalia F Callaway, Cassie A Ludwig, Mark S Blumenkranz, Jennifer Michelle Jones, Douglas R Fredrick, Darius M Moshfeghi
PURPOSE: To report the birth prevalence, risk factors, characteristics, and location of fundus hemorrhages (FHs) of the retina and optic nerve present in newborns at birth. DESIGN: Prospective cohort study at Stanford University School of Medicine. PARTICIPANTS: All infants who were 37 weeks postmenstrual age or older and stable were eligible for screening. Infants with known or suspected infectious conjunctivitis were excluded. METHODS: Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013, through July 25, 2014, were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test study...
May 2016: Ophthalmology
T R Padhi, T Das, S Rath, L Pradhan, S Sutar, K G Panda, R Modi, S Jalali
PURPOSE: To evaluate the serial changes in retinal vasculature in infants treated with intravitreal bevacizumab (IVB) for aggressive posterior retinopathy of prematurity (APROP) in zone I. METHODS: Retrospective analysis of serial changes in retinal vasculature after IVB in the seven eyes of four babies with APROP in zone I. RESULTS: The initial regression, following IVB, was dramatic with reduction in vessel caliber and marked thinning and invisibility of the bridging shunts...
March 2016: Eye
Ali Kanık, Osman Tolga İnce, Şehriban Yeşiloğlu, Kayı Eliaçık, Ali Rahmi Bakiler
Abusive head trauma is a serious form of child abuse and mostly seen in infants below the age of two years as a result of a strong shaking by the caregiver who aims to stop the infant's crying. Characteristic symptoms include subdural hematomas, encephalopathy, retinal hemorrhages and fractures of the long bones. When physically examined, there are generally no externally visible signs. For this reason, it can be underdiagnosed, if it is not considered in the differential diagnosis. When the information provided from the parents is inconsistent and contradictory with the clinical picture of the patient, this form of abuse must be suspected and retinal hemorrhages should be searched...
September 2015: Türk Pediatri Arşivi
Mohan J Narayanan, Sampathkumar Rangasamy, Vinodh Narayanan
Incontinentia pigmenti (IP; Bloch-Sulzberger syndrome; OMIM #308300) is an X-linked dominant neurocutaneous disorder with presumed male lethality. It is usually diagnosed in female newborns based on skin features (erythematous, vesicular, or bullous eruption in linear streaks). The skin lesions evolve into a verrucous stage, followed by atrophy and scarring, leaving linear areas of hypopigmentation and hyperpigmented macules in bizarre patterns following Blaschko's lines. Systemic and neurologic complications include focal seizures and hemorrhagic cerebral infarction in infants, and retinal vasculopathy leading to blindness...
2015: Handbook of Clinical Neurology
James R Lauridson, Kristy L Cromblin
This is the case of a 4-month-old male infant whose mother sought medical care because of poor feeding and low-grade temperature. The infant had no external evidence of abuse, but chest radiographs showed multiple bilateral rib fractures. There were no retinal hemorrhages. Investigation revealed that the father had repeatedly squeezed the child to unconsciousness. The cardiopulmonary effects of this form of abuse are restriction of respiration and reduced cardiac output. This is an unusual case of occult child abuse...
December 2015: American Journal of Forensic Medicine and Pathology
Marc De Leeuw, Emile Beuls, Philippe G Jorens, Paul Parizel, Werner Jacobs
In young infants, the triad consisting of acute encephalopathy, retinal hemorrhages, and a subdural hematoma is a nonspecific finding. It has traumatic and non-traumatic etiologies. The triad may be found among a vast spectrum of natural diseases. Optic nerve sheath hemorrhage in infants is typically detected at autopsy. It is a nonspecific finding that can be found in traumatic and non-traumatic etiologies. Neither the triad nor the ONSH are pathognomonic for an abusive head injury. Opposite to the triad, the spectrum of non-traumatic etiologies of ONSH is limited...
November 2015: Journal of Forensic and Legal Medicine
Babette Bais, Bela Kubat, Ehsan Motazedi, Robert M Verdijk
PURPOSE: To investigate β-amyloid precursor protein (β-APP), ubiquitin, and glial fibrillary acid protein (GFAP) immunostaining as a diagnostic tool to aid in the discrimination between abusive head trauma and nonabusive head trauma in postmortem ocular histopathologic investigation. DESIGN: Retrospective cross-sectional study. METHODS: Seventy-four eyes of 37 infants were studied for hemorrhage and immunohistochemical expression of β-APP, ubiquitin, and GFAP in the retina and optic nerve...
December 2015: American Journal of Ophthalmology
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