(HealthDay News) – In children <3 years, a high dot-blot count for retinal hemorrhages (RHs) is a strong predictor of inflicted traumatic brain injury (ITBI) rather than accidental traumatic brain injury (ATBI).

Robert A. Minns, MB, BS, PhD, of the Royal Hospital for Sick Children in Edinburgh, UK, and colleagues conducted a six-year, observational, prospective study involving 114 infants and young children admitted to the pediatric intensive care unit with traumatic and nontraumatic encephalopathies. The authors sought to evaluate whether RHs, observed using wide-field retinal imaging within 24 hours, could be used to reliably distinguish between ITBI and ATBI.

The researchers noted significant differences in the average number of RHs as well as in their location and depth. RHs associated with ATBI were near the optic disc and more superficial than those in ITBI. In contrast, RH due to ITBI tended to be more peripheral and involve deeper layers. In children <3 years with >25 dot-blot (intraretinal) hemorrhages, the positive predictive value for ITBI was 93%.

“This article presents the first prospective study with objectively measured RHs from all possible etiologies in children and predicts inflicted brain injury from certain RH characteristics alone,” the authors write.

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