International Journal of Legal Medicine

, Volume 123, Issue 3, pp 189–197 | Cite as

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

  • Jakob MatschkeEmail author
  • Klaus Püschel
  • Markus Glatzel
Review Article


Retinal and optic nerve sheath hemorrhages are an essential part of the various forms of inflicted neurotrauma in infants, especially in its most common variant, the shaken baby syndrome (SBS). Clinically, ophthalmologists play an important part for the diagnosis and further management of patients with SBS. For the forensic pathologist, a thorough understanding of the basic principles behind the morphological phenomena commonly encountered in the orbita is required. This review summarizes the present knowledge of ocular pathology in inflicted infantile neurotrauma, focusing strongly on SBS. Furthermore, a review of the most recent literature on the subject is given.


Forensic neuropathology Shaken baby syndrome Non-accidental head injury Ocular pathology 


  1. 1.
    Adams G, Ainsworth J, Butler L et al (2004) Update from the ophthalmology child abuse working party: Royal College Ophthalmologists. Eye 18:795–798PubMedCrossRefGoogle Scholar
  2. 2.
    American Academy of Pediatrics (2001) Shaken baby syndrome: rotational cranial injuries—technical report. Pediatrics 108:206–210CrossRefGoogle Scholar
  3. 3.
    Arlotti SA, Forbes BJ, Dias MS, Bonsall DJ (2007) Unilateral retinal hemorrhages in shaken baby syndrome. J AAPOS 11:175–178PubMedCrossRefGoogle Scholar
  4. 4.
    Arnold RW (2003) Macular hole without hemorrhages and shaken baby syndrome: practical medicolegal documentation of children's eye trauma. J Pediatr Ophthalmol Strabismus 40:355–357PubMedGoogle Scholar
  5. 5.
    Aryan HE, Ghosheh FR, Jandial R, Levy ML (2005) Retinal hemorrhage and pediatric brain injury: etiology and review of the literature. J Clin Neurosci 12:624–631PubMedCrossRefGoogle Scholar
  6. 6.
    Bacon CJ, Sayer GC, Howe JW (1978) Extensive retinal haemorrhages in infancy—an innocent cause. Br Med J 1:281PubMedCrossRefGoogle Scholar
  7. 7.
    Baum JD, Bulpitt CJ (1970) Retinal and conjunctival haemorrhage in the newborn. Arch Dis Child 45:344–349PubMedCrossRefGoogle Scholar
  8. 8.
    Betz P, Puschel K, Miltner E, Lignitz E, Eisenmenger W (1996) Morphometrical analysis of retinal hemorrhages in the shaken baby syndrome. Forensic Sci Int 78:71–80PubMedCrossRefGoogle Scholar
  9. 9.
    Brown SM, Shami M (1999) Optic disc neovascularization following severe retinoschisis due to shaken baby syndrome. Arch Ophthalmol 117:838–839PubMedGoogle Scholar
  10. 10.
    Brown SM, Bradley JC (2007) Hemorrhagic posterior vitreous detachment without intraretinal hemorrhage in a shaken infant. Arch Ophthalmol 125:1301PubMedCrossRefGoogle Scholar
  11. 11.
    Budenz DL, Farber MG, Mirchandani HG, Park H, Rorke LB (1994) Ocular and optic nerve hemorrhages in abused infants with intracranial injuries. Ophthalmology 101:559–565PubMedGoogle Scholar
  12. 12.
    Buys YM, Levin AV, Enzenauer RW et al (1992) Retinal findings after head trauma in infants and young children. Ophthalmology 99:1718–1723PubMedGoogle Scholar
  13. 13.
    Cackett P, Fleck B, Mulhivill A (2004) Bilateral fourth-nerve palsy occurring after shaking injury in infancy. J AAPOS 8:280–281PubMedCrossRefGoogle Scholar
  14. 14.
    Caffey J (1946) Multiple fractures in the long bones of infants suffering from chronic subdural hematoma. Am J Roentgenol 56:163–173Google Scholar
  15. 15.
    Caffey J (1972) On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation. Am J Dis Child 124:161–169PubMedGoogle Scholar
  16. 16.
    Carrigan TD, Walker E, Barnes S (2000) Domestic violence: the shaken adult syndrome. J Accid Emerg Med 17:138–139PubMedGoogle Scholar
  17. 17.
    Chan J (1994) Ophthalmic complications after bungee jumping. Br J Ophthalmol 78:239PubMedCrossRefGoogle Scholar
  18. 18.
    Christian CW, Taylor AA, Hertle RW, Duhaime AC (1999) Retinal hemorrhages caused by accidental household trauma. J Pediatr 135:125–127PubMedCrossRefGoogle Scholar
  19. 19.
    Clark RS, Orr RA, Atkinson CS, Towbin RB, Pang D (1995) Retinal hemorrhages associated with spinal cord arteriovenous malformation. Clin Pediatr (Phila) 34:281–283Google Scholar
  20. 20.
    Currie AD, Bentley CR, Bloom PA (2001) Retinal haemorrhage and fatal stroke in an infant with fibromuscular dysplasia. Arch Dis Child 84:263–264PubMedCrossRefGoogle Scholar
  21. 21.
    David DB, Mears T, Quinlan MP (1994) Ocular complications associated with bungee jumping. Br J Ophthalmol 78:234–235PubMedCrossRefGoogle Scholar
  22. 22.
    Drack AV, Petronio J, Capone A (1999) Unilateral retinal hemorrhages in documented cases of child abuse. Am J Ophthalmol 128:340–344PubMedCrossRefGoogle Scholar
  23. 23.
    Dubowitz H, Bennett S (2007) Physical abuse and neglect of children. Lancet 369:1891–1899PubMedCrossRefGoogle Scholar
  24. 24.
    Duhaime AC, Alario AJ, Lewander WJ et al (1992) Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age. Pediatrics 90:179–185PubMedGoogle Scholar
  25. 25.
    Ehlers N, Jensen IK, Hansen KB (1974) Retinal haemorrhages in the newborn. Comparison of delivery by forceps and by vacuum extractor. Acta Ophthalmol (Copenh) 52:73–82Google Scholar
  26. 26.
    Elder JE, Taylor RG, Klug GL (1991) Retinal haemorrhage in accidental head trauma in childhood. J Paediatr Child Health 27:286–289PubMedCrossRefGoogle Scholar
  27. 27.
    Ells AL, Kherani A, Lee D (2003) Epiretinal membrane formation is a late manifestation of shaken baby syndrome. J AAPOS 7:223–225PubMedCrossRefGoogle Scholar
  28. 28.
    Elner SG, Elner VM, Arnall M, Albert DM (1990) Ocular and associated systemic findings in suspected child abuse. A necropsy study. Arch Ophthalmol 108:1094–1101PubMedGoogle Scholar
  29. 29.
    Emerson MV, Pieramici DJ, Stoessel KM, Berreen JP, Gariano RF (2001) Incidence and rate of disappearance of retinal hemorrhage in newborns. Ophthalmology 108:36–39PubMedCrossRefGoogle Scholar
  30. 30.
    Ewing-Cobbs L, Kramer L, Prasad M et al (1998) Neuroimaging, physical, and developmental findings after inflicted and noninflicted traumatic brain injury in young children. Pediatrics 102:300–307PubMedCrossRefGoogle Scholar
  31. 31.
    Filipe JA, Pinto AM, Rosas V, Castro-Correia J (1994) Retinal complications after bungee jumping. Int Ophthalmol 18:359–360PubMedCrossRefGoogle Scholar
  32. 32.
    Fledelius HC (2005) Retinal haemorrhages in premature infants: a pathogenetic alternative diagnosis to child abuse. Acta Ophthalmol Scand 83:424–427PubMedCrossRefGoogle Scholar
  33. 33.
    Forbes BJ, Cox M, Christian CW (2008) Retinal hemorrhages in patients with epidural hematomas. J AAPOS 12:177–180PubMedCrossRefGoogle Scholar
  34. 34.
    Friendly DS (1971) Ocular manifestations of physical child abuse. Trans Am Acad Ophthalmol Otolaryngol 75:318–332PubMedGoogle Scholar
  35. 35.
    Gago LC, Wegner RK, Capone A Jr, Williams GA (2003) Intraretinal hemorrhages and chronic subdural effusions: glutaric aciduria type 1 can be mistaken for shaken baby syndrome. Retina 23:724–726PubMedCrossRefGoogle Scholar
  36. 36.
    Ganesh A, Jenny C, Geyer J, Shouldice M, Levin AV (2004) Retinal hemorrhages in type I osteogenesis imperfecta after minor trauma. Ophthalmology 111:1428–1431PubMedCrossRefGoogle Scholar
  37. 37.
    Gaynon MW, Koh K, Marmor MF, Frankel LR (1988) Retinal folds in the shaken baby syndrome. Am J Ophthalmol 106:423–425PubMedGoogle Scholar
  38. 38.
    Gerber P, Coffman K (2007) Nonaccidental head trauma in infants. Childs Nerv Syst 23:499–507PubMedCrossRefGoogle Scholar
  39. 39.
    Giangiacomo J, Khan JA, Levine C, Thompson VM (1988) Sequential cranial computed tomography in infants with retinal hemorrhages. Ophthalmology 95:295–299PubMedGoogle Scholar
  40. 40.
    Giles CL (1960) Retinal hemorrhages in the newborn. Am J Ophthalmol 49:1005–1011PubMedGoogle Scholar
  41. 41.
    Gilkes MJ, Mann TP (1967) Fundi of battered babies. Lancet 2:468–469CrossRefGoogle Scholar
  42. 42.
    Gilliland MG, Folberg R (1992) Retinal hemorrhages: replicating the clinician's view of the eye. Forensic Sci Int 56:77–80PubMedCrossRefGoogle Scholar
  43. 43.
    Gilliland MG, Luckenbach MW (1993) Are retinal hemorrhages found after resuscitation attempts? A study of the eyes of 169 children. Am J Forensic Med Pathol 14:187–192PubMedGoogle Scholar
  44. 44.
    Gilliland MG, Luckenbach MW, Chenier TC (1994) Systemic and ocular findings in 169 prospectively studied child deaths: retinal hemorrhages usually mean child abuse. Forensic Sci Int 68:117–132PubMedCrossRefGoogle Scholar
  45. 45.
    Gilliland MG, Luthert P (2003) Why do histology on retinal haemorrhages in suspected non-accidental injury? Histopathology 43:592–602PubMedCrossRefGoogle Scholar
  46. 46.
    Gilliland MG, Levin AV, Enzenauer RW et al (2007) Guidelines for postmortem protocol for ocular investigation of sudden unexplained infant death and suspected physical child abuse. Am J Forensic Med Pathol 28:323–329PubMedCrossRefGoogle Scholar
  47. 47.
    Gnanaraj L, Gilliland MG, Yahya RR, Rutka JT, Drake J, Dirks P, Levin AV (2007) Ocular manifestations of crush head injury in children. Eye 21:5–10PubMedCrossRefGoogle Scholar
  48. 48.
    Goetting MG, Sowa B (1990) Retinal hemorrhage after cardiopulmonary resuscitation in children: an etiologic reevaluation. Pediatrics 85:585–588PubMedGoogle Scholar
  49. 49.
    Goldman M, Dagan Z, Yair M, Elbaz U, Lahat E, Yair M (2006) Severe cough and retinal hemorrhage in infants and young children. J Pediatr 148:835–836PubMedCrossRefGoogle Scholar
  50. 50.
    Green MA, Lieberman G, Milroy CM, Parsons MA (1996) Ocular and cerebral trauma in non-accidental injury in infancy: underlying mechanisms and implications for paediatric practice. Br J Ophthalmol 80:282–287PubMedCrossRefGoogle Scholar
  51. 51.
    Greenwald MJ, Weiss A, Oesterle CS, Friendly DS (1986) Traumatic retinoschisis in battered babies. Ophthalmology 93:618–625PubMedGoogle Scholar
  52. 52.
    Guthkelch AN (1971) Infantile subdural haematoma and its relationship to whiplash injuries. Br Med J 2:430–431PubMedCrossRefGoogle Scholar
  53. 53.
    Harcourt B, Hopkins D (1971) Ophthalmic manifestations of the battered-baby syndrome. Br Med J 3:398–401PubMedCrossRefGoogle Scholar
  54. 54.
    Hartley LM, Khwaja OS, Verity CM (2001) Glutaric aciduria type 1 and nonaccidental head injury. Pediatrics 107:174–175PubMedCrossRefGoogle Scholar
  55. 55.
    Healey K, Schrading W (2006) A case of shaken baby syndrome with unilateral retinal hemorrhage with no associated intracranial hemorrhage. Am J Emerg Med 24:616–617PubMedCrossRefGoogle Scholar
  56. 56.
    Herr S, Pierce MC, Berger RP, Ford H, Pitetti RD (2004) Does Valsalva retinopathy occur in infants? An initial investigation in infants with vomiting caused by pyloric stenosis. Pediatrics 113:1658–1661PubMedCrossRefGoogle Scholar
  57. 57.
    Hughes LA, May K, Talbot JF, Parsons MA (2006) Incidence, distribution, and duration of birth-related retinal hemorrhages: a prospective study. J AAPOS 10:102–106PubMedCrossRefGoogle Scholar
  58. 58.
    Innocenti E, Bell TA (1994) Ocular injury resulting from bungee-cord jumping. Eye 8:710–711PubMedGoogle Scholar
  59. 59.
    Jain BK, Talbot EM (1994) Bungee jumping and intraocular haemorrhage. Br J Ophthalmol 78:236–237PubMedCrossRefGoogle Scholar
  60. 60.
    Johnson DL, Braun D, Friendly D (1993) Accidental head trauma and retinal hemorrhage. Neurosurgery 33:231–234 discussion 234–235PubMedCrossRefGoogle Scholar
  61. 61.
    Kanter RK (1986) Retinal hemorrhage after cardiopulmonary resuscitation or child abuse. J Pediatr 108:430–432PubMedCrossRefGoogle Scholar
  62. 62.
    Kapoor S, Schiffman J, Tang R, Kiang E, Li H, Woodward J (1997) The significance of white-centered retinal hemorrhages in the shaken baby syndrome. Pediatr Emerg Care 13:183–185PubMedCrossRefGoogle Scholar
  63. 63.
    Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK (1962) The battered-child syndrome. JAMA 181:17–24PubMedGoogle Scholar
  64. 64.
    Kiffney GT Jr (1964) The eye of the “battered child”. Arch Ophthalmol 72:231–233PubMedGoogle Scholar
  65. 65.
    Kivlin JD, Simons KB, Lazoritz S, Ruttum MS (2000) Shaken baby syndrome. Ophthalmology 107:1246–1254PubMedCrossRefGoogle Scholar
  66. 66.
    Kivlin JD (2001) Manifestations of the shaken baby syndrome. Curr Opin Ophthalmol 12:158–163PubMedCrossRefGoogle Scholar
  67. 67.
    Kwok AK, So AK, Lam SW, Ng JS, Fok TF, Lam DS (2000) Can vitreous haemorrhage indicate non-accidental injury if mild retinopathy of prematurity is present? Eye 14:812–813PubMedGoogle Scholar
  68. 68.
    Lantz PE, Sinal SH, Stanton CA, Weaver RG (2004) Perimacular retinal folds from childhood head trauma. BMJ 328:754–756PubMedCrossRefGoogle Scholar
  69. 69.
    Lash SC, Williams CP, Luff AJ, Hodgkins PR (2004) 360 degree giant retinal tear as a result of presumed non-accidental injury. Br J Ophthalmol 88:155PubMedCrossRefGoogle Scholar
  70. 70.
    Levin AV (2002) Ophthalmology of shaken baby syndrome. Neurosurg Clin N Am 13:201–211PubMedCrossRefGoogle Scholar
  71. 71.
    Levin S, Janive J, Mintz M et al (1980) Diagnostic and prognostic value of retinal hemorrhages in the neonate. Obstet Gynecol 55:309–314PubMedGoogle Scholar
  72. 72.
    Levine LM (2003) Pediatric ocular trauma and shaken infant syndrome. Pediatr Clin North Am 50:137–148PubMedCrossRefGoogle Scholar
  73. 73.
    Lueder GT, Turner JW, Paschall R (2006) Perimacular retinal folds simulating nonaccidental injury in an infant. Arch Ophthalmol 124:1782–1783PubMedCrossRefGoogle Scholar
  74. 74.
    Lyle DJ, Stapp JP, Button R (1956) Ophthalmological hydrostatic pressure syndrome. Trans Am Ophthalmol Soc 54:121–128PubMedGoogle Scholar
  75. 75.
    Macgregor DL (2008) Shaken baby syndrome: the quest for evidence. Dev Med Child Neurol 50:8PubMedGoogle Scholar
  76. 76.
    Marshman WE, Adams GG, Ohri R (1999) Bilateral vitreous hemorrhages in an infant with low fibrinogen levels. J AAPOS 3:255–256PubMedCrossRefGoogle Scholar
  77. 77.
    Massicotte SJ, Folberg R, Torczynski E, Gilliland MG, Luckenbach MW (1991) Vitreoretinal traction and perimacular retinal folds in the eyes of deliberately traumatized children. Ophthalmology 98:1124–1127PubMedGoogle Scholar
  78. 78.
    Matschke J (2008) Historical overview of non-accidental head injury in toddlers and infants. Rechtsmedizin 18:7–8CrossRefGoogle Scholar
  79. 79.
    McCabe CF, Donahue SP (2000) Prognostic indicators for vision and mortality in shaken baby syndrome. Arch Ophthalmol 118:373–377PubMedGoogle Scholar
  80. 80.
    Mei-Zahav M, Uziel Y, Raz J, Ginot N, Wolach B, Fainmesser P (2002) Convulsions and retinal haemorrhage: should we look further? Arch Dis Child 86:334–335PubMedCrossRefGoogle Scholar
  81. 81.
    Morad Y, Kim YM, Armstrong DC, Huyer D, Mian M, Levin AV (2002) Correlation between retinal abnormalities and intracranial abnormalities in the shaken baby syndrome. Am J Ophthalmol 134:354–359PubMedCrossRefGoogle Scholar
  82. 82.
    Morad Y, Kim YM, Mian M, Huyer D, Capra L, Levin AV (2003) Nonophthalmologist accuracy in diagnosing retinal hemorrhages in the shaken baby syndrome. J Pediatr 142:431–434PubMedCrossRefGoogle Scholar
  83. 83.
    Mulvihill A, Buncic JR (2004) Vertical sensory nystagmus associated with intraocular haemorrhages in the shaken baby syndrome. Eye 18:545–546PubMedCrossRefGoogle Scholar
  84. 84.
    Mungan NK (2007) Update on shaken baby syndrome: ophthalmology. Curr Opin Ophthalmol 18:392–397PubMedCrossRefGoogle Scholar
  85. 85.
    Munger CE, Peiffer RL, Bouldin TW, Kylstra JA, Thompson RL (1993) Ocular and associated neuropathologic observations in suspected whiplash shaken infant syndrome. A retrospective study of 12 cases. Am J Forensic Med Pathol 14:193–200PubMedGoogle Scholar
  86. 86.
    Mushin A, Morgan G (1971) Ocular injury in the battered baby syndrome. Report of two cases. Br J Ophthalmol 55:343–347PubMedCrossRefGoogle Scholar
  87. 87.
    Mushin AS (1971) Ocular damage in the battered-baby syndrome. Br Med J 3:402–404PubMedCrossRefGoogle Scholar
  88. 88.
    Newton AW, Vandeven AM (2007) Update on child maltreatment. Curr Opin Pediatr 19:223–229PubMedCrossRefGoogle Scholar
  89. 89.
    Noel LP, Clarke WN (1982) Self-inflicted ocular injuries in children. Am J Ophthalmol 94:630–633PubMedGoogle Scholar
  90. 90.
    Odom A, Christ E, Kerr N et al (1997) Prevalence of retinal hemorrhages in pediatric patients after in-hospital cardiopulmonary resuscitation: a prospective study. Pediatrics 99:E3PubMedCrossRefGoogle Scholar
  91. 91.
    Olver JM, Hague S (1989) Children presenting to an ophthalmic casualty department. Eye 3:415–419PubMedGoogle Scholar
  92. 92.
    Ommaya AK, Yarnell P (1969) Subdural haematoma after whiplash injury. Lancet 2:237–239PubMedGoogle Scholar
  93. 93.
    Ong T, Hodgkins P, Marsh C, Taylor D (2005) Blinding keratoconjunctivitis and child abuse. Am J Ophthalmol 139:190–191PubMedCrossRefGoogle Scholar
  94. 94.
    Ou JI, Moshfeghi DM, Tawansy K, Sears JE (2006) Macular hole in the shaken baby syndrome. Arch Ophthalmol 124:913–915PubMedCrossRefGoogle Scholar
  95. 95.
    Pierre-Kahn V, Roche O, Dureau P, Uteza Y, Renier D, Pierre-Kahn A, Dufier JL (2003) Ophthalmologic findings in suspected child abuse victims with subdural hematomas. Ophthalmology 110:1718–1723PubMedCrossRefGoogle Scholar
  96. 96.
    Pitetti RD, Maffei F, Chang K, Hickey R, Berger R, Pierce MC (2002) Prevalence of retinal hemorrhages and child abuse in children who present with an apparent life-threatening event. Pediatrics 110:557–562PubMedCrossRefGoogle Scholar
  97. 97.
    Planten JT, von der Schaaf PC (1971) Retinal haemorrhage in the newborn. An attempt to indicate and explain its cause and significance. Ophthalmologica 162:213–222PubMedCrossRefGoogle Scholar
  98. 98.
    Pounder DJ (1997) Shaken adult syndrome. Am J Forensic Med Pathol 18:321–324PubMedCrossRefGoogle Scholar
  99. 99.
    Raul JS, Roth S, Ludes B, Willinger R (2008) Influence of the benign enlargement of the subarachnoid space on the bridging veins strain during a shaking event: a finite element study. Int J Legal Med 122:337–340PubMedCrossRefGoogle Scholar
  100. 100.
    Riffenburgh RS, Sathyavagiswaran L (1991) The eyes of child abuse victims: autopsy findings. J Forensic Sci 36:741–747PubMedGoogle Scholar
  101. 101.
    Riffenburgh RS, Sathyavagiswaran L (1991) Ocular findings at autopsy of child abuse victims. Ophthalmology 98:1519–1524PubMedGoogle Scholar
  102. 102.
    Rogers MC, Nugent SK, Stidham GL (1979) Effects of closed-chest cardiac massage on intracranial pressure. Crit Care Med 7:454–456PubMedCrossRefGoogle Scholar
  103. 103.
    Roth S, Raul JS, Ludes B, Willinger R (2007) Finite element analysis of impact and shaking inflicted to a child. Int J Legal Med 121:223–228PubMedCrossRefGoogle Scholar
  104. 104.
    Sandramouli S, Robinson R, Tsaloumas M, Willshaw HE (1997) Retinal haemorrhages and convulsions. Arch Dis Child 76:449–451PubMedCrossRefGoogle Scholar
  105. 105.
    Schloff S, Mullaney PB, Armstrong DC et al (2002) Retinal findings in children with intracranial hemorrhage. Ophthalmology 109:1472–1476PubMedCrossRefGoogle Scholar
  106. 106.
    Schoenfeld A, Buckman G, Nissenkorn I, Cohen S, Ben-Sira I, Ovadia J (1985) Retinal hemorrhages in the newborn following labor induced by oxytocin or dinoprostone. Arch Ophthalmol 103:932–934PubMedGoogle Scholar
  107. 107.
    Sezen F (1971) Retinal haemorrhages in newborn infants. Br J Ophthalmol 55:248–253PubMedCrossRefGoogle Scholar
  108. 108.
    Shaw HE Jr, Landers MB, Sydnor CF (1977) The significance of intraocular hemorrhages due to subarachnoid hemorrhage. Ann Ophthalmol 9:1403–1405PubMedGoogle Scholar
  109. 109.
    Simons R, Krol J (1994) Visual loss from bungee jumping. Lancet 343:853PubMedCrossRefGoogle Scholar
  110. 110.
    Spirn MJ, Lynn MJ, Hubbard GB 3rd (2006) Vitreous hemorrhage in children. Ophthalmology 113:848–852PubMedCrossRefGoogle Scholar
  111. 111.
    Squier W (2008) Shaken baby syndrome: the quest for evidence. Dev Med Child Neurol 50:10–14PubMedCrossRefGoogle Scholar
  112. 112.
    Tardieu A (1860) Étude médico-légale sur les sévices et mauvais traitements exercés sur des enfants. Annales d’Hygiène Publique et de Medecine Légale 13:361–398Google Scholar
  113. 113.
    The Ophthalmology Child Abuse Working Party (1999) Child abuse and the eye. The Ophthalmology Child Abuse Working Party. Eye 13:3–10Google Scholar
  114. 114.
    Tomasi LG, Rosman NP (1975) Purtscher retinopathy in the battered child syndrome. Am J Dis Child 129:1335–1337PubMedGoogle Scholar
  115. 115.
    Tseng SS, Keys MP (1976) Battered child syndrome simulating congenital glaucoma. Arch Ophthalmol 94:839–840PubMedGoogle Scholar
  116. 116.
    Tyagi AK, Willshaw HE, Ainsworth JR (1997) Unilateral retinal haemorrhages in non-accidental injury. Lancet 349:1224PubMedCrossRefGoogle Scholar
  117. 117.
    Tyagi AK, Scotcher S, Kozeis N, Willshaw HE (1998) Can convulsions alone cause retinal haemorrhages in infants? Br J Ophthalmol 82:659–660PubMedCrossRefGoogle Scholar
  118. 118.
    Van Rens E (1994) Traumatic ocular haemorrhage related to bungee jumping. Br J Ophthalmol 78:948PubMedCrossRefGoogle Scholar
  119. 119.
    Weedn VW, Mansour AM, Nichols MM (1990) Retinal hemorrhage in an infant after cardiopulmonary resuscitation. Am J Forensic Med Pathol 11:79–82PubMedGoogle Scholar
  120. 120.
    Weidenthal DT, Levin DB (1976) Retinal detachment in a battered infant. Am J Ophthalmol 81:725–727PubMedGoogle Scholar
  121. 121.
    Weingeist TA, Goldman EJ, Folk JC, Packer AJ, Ossoinig KC (1986) Terson's syndrome. Clinicopathologic correlations. Ophthalmology 93:1435–1442PubMedGoogle Scholar
  122. 122.
    Wilkinson WS, Han DP, Rappley MD, Owings CL (1989) Retinal hemorrhage predicts neurologic injury in the shaken baby syndrome. Arch Ophthalmol 107:1472–1474PubMedGoogle Scholar
  123. 123.
    Wygnanski-Jaffe T, Levin AV, Shafiq A et al (2006) Postmortem orbital findings in shaken baby syndrome. Am J Ophthalmol 142:233–240PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Jakob Matschke
    • 1
    • 2
    • 3
    Email author
  • Klaus Püschel
    • 2
  • Markus Glatzel
    • 3
  1. 1.Forensic NeuropathologyUniversity Medical Centre Hamburg-EppendorfHamburgGermany
  2. 2.Institute of Legal MedicineUniversity Medical Centre Hamburg-EppendorfHamburgGermany
  3. 3.Institute of NeuropathologyUniversity Medical Centre Hamburg-EppendorfHamburgGermany

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