title: Incidence of retinal hemorrhages in abusive head trauma.
abstract: OBJECTIVE
  To evaluate whether a relationship exists between the presence of retinal hemorrhages and confessions and/or identified perpetrators in cases of abusive head trauma.
  
  
  METHODS
  A retrospective chart review was conducted of all abusive head trauma cases. All cases that met criteria for abusive head trauma were placed into one of three categories: perpetrator confessed (category A), perpetrator identified without confession (category B), and no perpetrator identified (category C).
  
  
  RESULTS
  Forty-eight cases met the criteria for abusive head trauma, with 18, 16, and 14 cases in categories A, B, and C, respectively. Retinal hemorrhages were identified in 16 of 18 (88%) cases in category A, 12 of 16 (75%) in category B, and 6 of 14 (43%) in category C. A statistically significant difference regarding the presence of retinal hemorrhages was seen for perpetrator identified (28 of 34 or 82%) compared to no perpetrator identified (6 of 14 or 43%) (P = .034). The difference in retinal hemorrhages was correlated to the higher incidence of acute presentation in the perpetrator identified group (31 of 34 or 91%) compared to that in the perpetrator not identified group (9 of 14 or 64%) (P = .023).
  
  
  CONCLUSIONS
  The incidence of retinal hemorrhages in abusive head trauma for identified perpetrators, regardless of a confession, is similar. However, there is a statistically significant decrease in the incidence of retinal hemorrhages in abusive head trauma when comparing identified perpetrators to non-identified perpetrators. This decreased incidence of retinal hemorrhages was statistically correlated to a lower incidence of acute presentation in victims of abusive head trauma without an identified perpetrator.[J Pediatr Ophthalmol Strabismus 2013;50(3):169-172.].
authors: Department of North Shore-Long Island Jewish Health Systems, Hofstra North Shore-LIJ School of Medicine at Hofstra University, -Long Island Jewish Health Systems, Great Neck, NY 11021, USA. Mgaffar@nshs.edu
authors: Majida A
authors: MA
authors: Gaffar
authors: Debra
authors: D
authors: Esernio-Jenssen
authors: Sylvia R
authors: SR
authors: Kodsi
mesh_terms: D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011379:Prognosis; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology