[Vitreous hemorrhage after accidental head injury with chest compression--case report].
Vitreous hemorrhage is relatively common following subarachnoid hemorrhage, but rarely occurs after accidental head injury. In this paper, we report a rare case of vitreous hemorrhage after an accidental head injury with chest compression. A 4-month-old girl was held in her father's arms. After he fell down, she struck her head and her chest was compressed by her father's body. She soon became pale and was immediately transported to our center complaining of disturbance of consciousness on February 6, 1993. On admission, she was semicomatose and had a generalized convulsion. Computed tomography (CT) scan showed a subdural hematoma, although no fracture was detected on the plain X-ray film. Bilateral vitreous hemorrhage was also observed. The anterior fontanelle pressure was a high 330 mmH2O. The patient was treated conservatively with agents to promote hemostasis and reduce the intracranial hypertension. She was discharged after one month with normal consciousness and improved vision. The follow-up CT scan revealed subdural hematoma, hemorrhagic infarction (suggesting rupture of the pontine veins), and cerebral atrophy, corresponding to those of the shaken baby syndrome. Her chest was compressed by her father's body. The anterior fontanelle pressure was a high 330 mmH2O. These findings suggest that shaking or abrupt deceleration, acute intrathoracic hypertension and acute intracranial hypertension, caused retinal hemorrhage, and that extensive retinal hemorrhage possibly resulted in vitreous hemorrhage.
Harada
K
K
Department of Neurosurgery, St. Mary's Hospital, Fukuoka, Japan.
Hayashi
T
T
Anegawa
S
S
Torigoe
R
R
Araki
T
T
Muraoka
Y
Y
Ono
E
E
Inoue
N
N
D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D013898:Thoracic Injuries / Q000150:complications*; D014057:Tomography, X-Ray Computed; D014823:Vitreous Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D014949:Wounds, Nonpenetrating / Q000150:complications*