Giangiacomo J, Khan J A, Levine C, Thompson V M
Department of Ophthalmology, University of Missouri-Columbia 65212.
Ophthalmology. 1988 Mar;95(3):295-9. doi: 10.1016/s0161-6420(88)33170-2.
Five whiplash-shaken infants presented initially with lethargy, vomiting, irritability, and intraocular hemorrhage and had sequential cranial computed tomography (CT). In three of the five infants, results of the initial CT scans of the head were either normal or demonstrated subtle abnormalities. However, significant subdural hemorrhages which were demonstrated by subdural aspiration developed subsequently in all three infants. Results of repeat CTs of the head showed progressive ventricular dilation and symmetrical bilateral fronto-parietal subdural hematomas. The retinal hemorrhages preceded both the clinical and radiologic recognition of subdural hematoma. Results of the initial head CT of the remaining two children showed intracerebral hemorrhages, cerebral edema and subsequently subdural hematoma. The finding of unexplained retinal hemorrhages in some infants, even though the initial CT head scan may show only minimal changes, warrants monitoring of the head circumference, fundus, and repeat head CT as indicated.
五名患有挥鞭样摇晃损伤的婴儿最初表现为嗜睡、呕吐、易激惹和眼内出血，并接受了系列头颅计算机断层扫描（CT）检查。在这五名婴儿中，有三名婴儿最初的头颅CT扫描结果正常或显示轻微异常。然而，随后这三名婴儿均经硬膜下穿刺证实出现了大量硬膜下出血。重复头颅CT检查结果显示脑室逐渐扩张以及双侧额顶叶硬膜下血肿对称出现。视网膜出血早于硬膜下血肿的临床和影像学诊断。其余两名儿童最初的头颅CT检查结果显示脑内出血、脑水肿，随后出现硬膜下血肿。即使一些婴儿最初的头颅CT扫描可能仅显示轻微变化，但发现无法解释的视网膜出血仍需根据情况监测头围、眼底并重复进行头颅CT检查。
