Retinal hemorrhage and brain injury patterns on diffusion-weighted magnetic resonance imaging in children with head trauma.
Publication/Presentation Date
12-1-2013
Abstract
PURPOSE: To evaluate associations between retinal hemorrhage severity and hypoxic-ischemic brain injury (HII) patterns by diffusion-weighted magnetic resonance imaging (DW-MRI) in young children with head trauma.
METHODS: DW-MRI images of a consecutive cohort study of children under age 3 years with inflicted or accidental head trauma who had eye examinations were analyzed by two independent masked examiners for type, severity, and location of primary lesions attributable to trauma, HII secondary to trauma, and mixed injury patterns. Retinal hemorrhage was graded retrospectively on a scale from 1 (none) to 5 (severe).
RESULTS: Retinal hemorrhage score was 3-5 in 6 of 7 patients with predominantly post-traumatic HII pattern and 4 of 32 who had traumatic injury without HII (P < 0.001) on DW-MRI imaging. Severe retinal hemorrhage was observed in absence of HII but only in inflicted injury. Retinal hemorrhage severity was correlated with HII severity (ρ = 0.53, P < 0.001) but not traumatic injury severity (ρ = -0.10, P = 0.50). HII severity was associated with retinal hemorrhage score 3-5 (P = 0.01), but traumatic injury severity was not (P = 0.37).
CONCLUSIONS: During inflicted head injury, a distinct type of trauma occurs causing more global brain injury with HII and more severe retinal hemorrhages. HII is not a necessary factor for severe retinal hemorrhage to develop from inflicted trauma.
Volume
17
Issue
6
First Page
603
Last Page
608
ISSN
1528-3933
Published In/Presented At
Binenbaum, G., Christian, C. W., Ichord, R. N., Ying, G. S., Simon, M. A., Romero, K., Pollock, A. N., & Forbes, B. J. (2013). Retinal hemorrhage and brain injury patterns on diffusion-weighted magnetic resonance imaging in children with head trauma. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 17(6), 603–608. https://doi.org/10.1016/j.jaapos.2013.09.002
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
24215807
Department(s)
Department of Pediatrics
Document Type
Article