Johnson D L, Braun D, Friendly D
Department of Surgery, Children's Hospital, Milton S. Hershey Medical Center, Penn State University, College of Medicine, Hershey.
Neurosurgery. 1993 Aug;33(2):231-4; discussion 234-5.
Retinal hemorrhage and intracranial hemorrhage in a child with little external evidence of trauma and with a poorly documented history are considered pathognomonic child abuse. The mechanism and magnitude of force required to produce the injuries are seldom witnessed or known. This study was designed to determine the incidence of retinal hemorrhage in pediatric head injuries under known accidental circumstances, in association with forces sufficient to cause skull fracture and/or intracranial hemorrhage. Of 525 consecutive hospital admissions for head injuries, 200 children filled these criteria. Thirty children were excluded because of suspected child abuse or gunshot wounds. Of the remaining 170, 140 were evaluated by an ophthalmologist for retinal hemorrhage. Two children, who were both involved in side-impact car accidents, had retinal hemorrhages in associated with severe head injury. Retinal hemorrhage occurs rarely in accidental head injury and is associated with extraordinary force.
在一个几乎没有外部创伤证据且病史记录不佳的儿童中出现视网膜出血和颅内出血，被视为虐待儿童的确切证据。造成这些损伤所需的力的机制和大小很少有人目睹或知晓。本研究旨在确定在已知意外情况下小儿头部损伤中视网膜出血的发生率，以及与足以导致颅骨骨折和/或颅内出血的力之间的关系。在连续525例因头部损伤入院的病例中，有200名儿童符合这些标准。由于怀疑存在虐待儿童或枪伤，30名儿童被排除。在其余170名儿童中，140名接受了眼科医生对视网膜出血的评估。两名儿童均遭遇侧面撞击的车祸，他们在严重头部损伤的同时伴有视网膜出血。视网膜出血在意外头部损伤中很少发生，且与巨大的外力有关。
