Poepel B, Seiberth V, Knorz M C, Kachel W
Augenklinik, Klinikum Mannheim, Fakultät für Klinische Medizin, Ruprecht-Karls-Universität Heidelberg, Mannheim.
Ophthalmologe. 1994 Jun;91(3):380-2.
Violent shaking is a type of child abuse which may cause intracranial hemorrhages combined with retinal and vitreous bleeding. Fundus bleeding is similar to that in Terson syndrome. However, in the shaken baby syndrome the intraocular hemorrhages may precede both the clinical and radiologic recognition of subdural haematoma.
We present a 4-months-old baby with convulsions and additional extensive bleeding of the fundus. Neither the ocular findings nor the seizures could be explained by minimal lesions of external trauma. Repeated cranial computed tomography showed increasing intracerebral bleeding with consecutive brain atrophy. Fundus bleeding completely disappeared.
When child abuse is suspected, ophthalmological examination is most important to detect fundus bleeding, which, in the absence of birth trauma or any other supportive evidence of external trauma or other diseases, is the leading symptom of the shaken baby syndrome.
剧烈摇晃是一种虐待儿童的形式,可能导致颅内出血并伴有视网膜和玻璃体出血。眼底出血与Terson综合征中的情况相似。然而,在摇晃婴儿综合征中,眼内出血可能先于硬膜下血肿的临床和影像学诊断出现。
我们报告一例4个月大的婴儿,伴有惊厥和眼底广泛出血。眼部检查结果和惊厥均无法用轻微的外部创伤来解释。重复进行的头颅计算机断层扫描显示脑内出血增多,并伴有连续性脑萎缩。眼底出血完全消失。
当怀疑存在虐待儿童情况时,眼科检查对于发现眼底出血最为重要,在没有出生创伤或任何其他外部创伤或其他疾病的支持证据时,眼底出血是摇晃婴儿综合征的主要症状。