title: [Retinal haemorrhages as a symptom of child abuse].
abstract: Inflicted traumatic brain injury (ITBI) - a possible result of child abuse - is difficult to diagnose, yet the diagnosis bears great impact on patients and their relatives. The purpose of this paper is to describe ophthalmologic findings that can be seen in relation to ITBI. For exemplification, three different cases are described in detail. ITBI is diagnosed through a multidisciplinary approach by exclusion of other causes that could explain the clinical findings, and by linking factors that together raise a high suspicion of ITBI. The typical triad of ITBI includes intracerebral haemorrhage, encephalopathy and retinal haemorrhages. Therefore, detailed fundus examination by an ophthalmologist is important when ITBI is suspected. A pattern of bilateral, multiple retinal haemorrhages present in different retinal layers and widespread from posterior pole to the retinal periphery, is highly suspicious for ITBI, and contributes to the final diagnosis.
authors.affiliation: Universitair Medisch Centrum Utrecht, afd. Oogheelkunde, Utrecht.
authors.forename: C M L
authors.initials: CM
authors.lastname: van den Hoven
authors.forename: F M C
authors.initials: FM
authors.lastname: van Berkestijn
authors.forename: I M B
authors.initials: IM
authors.lastname: Russel-Kampschoer
authors.forename: W A
authors.initials: WA
authors.lastname: Karst
authors.forename: E S M
authors.initials: ES
authors.lastname: Voskuil-Kerkhof
mesh_terms: D002649:Child Abuse / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D012166:Retinal Hemorrhage / Q000209:etiology*