Retinal hemorrhages as a predictor of inflicted traumatic (ITBI) or accidental (ATBI) brain injury
Retinal hemorrhages occur following traumatic brain injury, and many medical conditions. They may be subdivided into:
a) "subhyaloid and pre-retinal hemorrhages"
b) relatively superficial "flame-shaped" hemorrhages (within the nerve fiber layer)
c) "sub retinal" and "sub retina" pigment hemorrhages
d) "dot-blot" hemorrhages located in the deeper inner nuclear and outer plexiform layers whose cells run vertically
A prospective study using wide-field retinal and digital color/gray scale imaging evaluated, within 24 hours of admission to a PICU, the position, depth and number of hemorrhages associated with either ATBI or ITBI.
"Dot-blot" retinal hemorrhages in young children (<3yrs of age) appear strongly predictive of intentional traumatic brain injury (ITBI).