Description of retinal haemorrhages in children with accidental head injuries
| Age (years) | Accident | Type of haemorrhages | Grade* | Other findings† |
|---|---|---|---|---|
| Under 2 | Asphyxiated | Bilateral. Scattered intra-retinal, posterior pole and mid-periphery, 50% white-centred | 1 | SAH, HII, cerebral oedema, cortical venous thrombosis. No SDH |
| Over 2 | Knocked out by falling object | Bilateral. Pre-retinal and deeper intra-retinal, including flame-shaped, white-centred and deeper blot retinal haemorrhages, posterior pole | 2 | Bilateral SAH |
| Over 2 | Fell 1–2 m from play equipment | Bilateral. Numerous intra-retinal, posterior pole and mid-peripheral | 2 | Unilateral SDH |
| Under 2 | Fell 1.35 m, striking occiput | Bilateral. Several scattered blot haemorrhages around the posterior pole with occasional blot haemorrhages in periphery | 2 | Occipital skull fracture, unilateral SDH |
| Over 2 | Fell 1.5 m from play equipment | Unilateral. Occasional small flame haemorrhages, posterior pole. 1 small blot haemorrhage with a white centre, 2 small round pre-retinal adjacent to the central macula | 1 | Unilateral SDH and hemispheric infarction |
| Under 2 | Fell 2 m | Unilateral. Two small intra-retinal haemorrhages, posterior pole | 1 | Parietal skull fracture, unilateral SDH |
*Retinal haemorrhages graded following Vinchon.15
†Including negative skeletal surveys in five children ≤2 years old.
HII, hypoxic ischaemic injury; SAH, subarachnoid haemorrhage; SDH, subdural haemorrhage.