Correlations of intracranial pathology and cause of head injury with retinal hemorrhage in infants and toddlers: A multicenter, retrospective study by the J-HITs (Japanese Head injury of Infants and Toddlers study) group.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Brain Edema*/complications ; Child Abuse*/diagnosis ; Craniocerebral Trauma*/complications ; Craniocerebral Trauma*/diagnostic imaging; Child, Preschool ; Humans ; Infant ; East Asian People ; Hematoma, Subdural/diagnostic imaging ; Hematoma, Subdural/etiology ; Retinal Hemorrhage/etiology ; Retinal Hemorrhage/complications ; Retrospective Studies

Introduction: In infants who have suffered head trauma there are two possible explanations for retinal hemorrhage (RH): direct vitreous shaking and occurrence in association with intracranial lesions. Which possibility is more plausible was examined.
Material and Methods: This multicenter, retrospective study reviewed the clinical records of children younger than four years with head trauma who had been diagnosed with any findings on head computed tomography (CT) and/or magnetic resonance imaging (MRI). Of 452 cases, 239 underwent an ophthalmological examination and were included in this study. The relationships of RH with intracranial findings and the cause of injury were examined.
Result: Odds ratios for RH were significant for subdural hematoma (OR 23.41, p = 0.0004), brain edema (OR 5.46, p = 0.0095), nonaccidental (OR 11.26, p<0.0001), and self-inflicted falls (OR 6.22, p = 0.0041).
Conclusion: Although nonaccidental, brain edema and self-inflicted falls were associated with RH, subdural hematoma was most strongly associated with RH.
Competing Interests: Masahiro Nonaka and Young-Soo Park have written statements and appeared in court in child abuse cases both on the request of the prosecutor and the defense. Atsuko Harada has written statements and appeared in court in child abuse cases on the request of the prosecutor. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2023 Kato et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

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Date Created: 20230317 Date Completed: 20230322 Latest Revision: 20230418

20250114

PMC10022784

10.1371/journal.pone.0283297

36930676