Evaluation and management of retinal hemorrhages in infants with and without abusive head trauma
Evaluation and management of retinal hemorrhages in infants with and without abusive head trauma
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DOI：
10.1016/j.jaapos.2010.03.002
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发表时间：
2010-06-01
期刊：
影响因子：
1.6
通讯作者：
Levin, Alex V.
中科院分区：
文献类型：
--
作者：
Forbes, Brian J.;Rubin, Steven E.;Levin, Alex V.
在急性脑损伤的情况下，在没有严重意外创伤史或潜在医学原因的情况下，幼儿的广泛眼内出血必须被认为是非意外伤害，除非另有证明。在没有任何明显解释的情况下，任何视网膜出血的存在都应该在鉴别诊断中增加虐待性头部创伤的可能性，并可能导致骨骼X光检查和神经影像学检查，咨询儿童虐待专家，以及其他相关系统性疾病的检查。负责治疗婴儿和儿童的医生必须向儿童福利机构报告疑似虐待儿童的情况，以便进行调查，而眼科医生在遇到有眼部虐待表现的儿童时，需要确保采取适当措施，保护患者免受进一步伤害。确定虐待性头部创伤对于防止潜在致命的复发至关重要。（J AAPOS 2010;14：267-273）
Extensive intraocular hemorrhage in young infants in the setting of acute brain injury and in the absence of a history of severe accidental trauma or underlying medical cause must be considered to be nonaccidental injury until otherwise proven. In the absence of any obvious explanation, the presence of any retinal hemorrhage should raise the possibility of abusive head trauma in the differential diagnosis and perhaps lead to such testing as skeletal radiography and neuroimaging, consultation with a child abuse specialist, as well as workup for other relevant systemic conditions. Physicians who treat infants and children are mandated to report suspected child abuse to child welfare agencies for investigation, and ophthalmologists who encounter children with ophthalmic manifestations of abuse need to ensure that the proper steps are taken to protect their patients from the potential for further harm. Ascertainment of abusive head trauma is critical to prevent a potentially fatal recurrence. (J AAPOS 2010;14:267-273)