The Experts below are selected from a list of 2307 Experts worldwide ranked by ideXlab platform
Jane D. Kivlin - One of the best experts on this subject based on the ideXlab platform.
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Chapter Eight: Ophthalmic Manifestations of Shaken Baby Syndrome
Journal of Aggression Maltreatment & Trauma, 2001Co-Authors: Jane D. KivlinAbstract:Summary Retinal hemorrhages are the most common ocular finding in Shaken Baby Syndrome. Retinal hemorrhages cannot be dated clinically or histopathologically. Non-ophthalmologists have great difficulty in seeing RH when limited by direct ophthalmoscopy and undilated pupils. There are many other causes, but ophthalmologists are not always aware of Shaken Baby Syndrome in the differential of RH. While retinal injuries can cause loss of vision, the most common cause of blindness in SBS is direct bilateral injury to the visual pathways of the brain.
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Manifestations of the Shaken Baby Syndrome.
Current opinion in ophthalmology, 2001Co-Authors: Jane D. KivlinAbstract:Retinal hemorrhages are the most common fundus finding in the Shaken Baby Syndrome. They vary in type and location; no particular type is pathognomonic for the condition. Retinal hemorrhages are not needed to make a diagnosis of Shaken Baby Syndrome. However, in a child under age 3 years, the presence of extensive bilateral retinal hemorrhages raises a very strong possibility of abuse, which must be investigated. The other possible causes for hemorrhages in this age child can be investigated and eliminated. The diagnosis of abuse should be made by someone particularly trained in this area, who can put together the entire picture of inadequate or changing history, fractures of various ages, particularly rib fractures, subdural hematoma of the brain, and retinal hemorrhages. Photographs of retinal hemorrhages are very helpful to child advocacy experts who take these cases to court.
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Shaken Baby Syndrome.
Ophthalmology, 2000Co-Authors: Jane D. Kivlin, Kenneth B. Simons, Stephen Lazoritz, Mark S. RuttumAbstract:Abstract Purpose To examine the comprehensive ophthalmologic experience with the Shaken Baby Syndrome at one medical center, including clinical findings, autopsy findings, and the outcome of survivors. Design Retrospective, noncomparative case series. Participants One hundred twenty-three children admitted from January 1987 through December 1998 for subdural hematomas of the brain secondary to abuse were included. Methods Clinical features of eye examinations of the patients during their admission and after discharge and histopathologic observations for patients who died were retrieved from medical records and statistically analyzed. Main outcome measures Visual response and pupillary response on initial examination, fundus findings, final vision, neurologic outcome of survivors, and death. Results Ninety percent of the patients had ophthalmologic assessments. Retinal hemorrhages were detected in 83% of the examined children. The retinal hemorrhages were bilateral in 85% of affected children and varied in type and location. Nonophthalmologists missed the hemorrhages in 29% of affected patients. Poor visual response, poor pupillary response, and retinal hemorrhage correlated strongly with the demise of the child. One child who died had pigmented retinal scars from previous abuse, a condition not previously observed histopathologically to our knowledge. One fifth of the survivors had poor vision, largely the result of cerebral visual impairment. Severe neurologic impairment correlated highly with loss of vision. Conclusions Shaken Baby Syndrome causes devastating injury to the brain and thus to vision. Retinal hemorrhages are extremely common, but vision loss is most often the result of brain injury. The patient's visual reaction and pupillary response on presentation showed a high correlation with survival. Good initial visual reaction was highly correlated with good final vision and neurologic outcome. According to the literature, when retinal hemorrhages are found in young children, the likelihood that abuse occurred is very high. Nonophthalmologists' difficulty in detecting retinal hemorrhages may be an important limiting factor in identifying Shaken babies so they can be protected from further abuse.
Nils Mungan - One of the best experts on this subject based on the ideXlab platform.
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Update on Shaken Baby Syndrome: ophthalmology.
Current opinion in ophthalmology, 2007Co-Authors: Nils MunganAbstract:PURPOSE OF REVIEW: Shaken Baby Syndrome is a common problem with a high morbidity and mortality. Ophthalmologists help manage this condition and therefore must keep abreast of current advances. RECENT FINDINGS: Clinical updates include the discovery that retinal folds and traumatic retinoschisis can very rarely occur after crush head injury, but remain specific for Shaken Baby Syndrome in other scenarios. Pathology updates include new studies on orbital histology and woodpecker anatomy that suggest the retinal and optic nerve hemorrhages in Shaken Baby Syndrome are caused by shaking itself rather than secondary to intracranial pathology. Regarding this shaking injury, some primary prevention strategies have proven surprisingly effective. In the near future, serum biomarkers may be used as a screening tool for inflicted neurotrauma. Animal models such as the neonatal pig and computer models using finite element analysis are promising experimental techniques for studying Shaken Baby Syndrome. Finally, child abuse recently became an accredited subspecialty of pediatrics, which will lead to further advances in patient care, education, research and prevention. SUMMARY: Ophthalmologists play a key role in the diagnosis of Shaken Baby Syndrome. In addition, they are in a unique position to study ophthalmic aspects of the Syndrome, which in turn furthers the overall understanding of this devastating condition. Language: en
Eriksson A. - One of the best experts on this subject based on the ideXlab platform.
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Shaken Baby Syndrome and the risk of losing scientific scrutiny
'Wiley', 2017Co-Authors: Rosén M., Lynøe N., Elinder C-g, Hallberg B, Sundgren P., Eriksson A.Abstract:A systematic review of Shaken Baby Syndrome by the Swedish Agency for Health Technology Assessment and Assessment of Social Services generated numerous reactions from professional organisations, even before the review was published. There was also a lively debate after a paper summarising its findings were published in Acta Paediatrica The various responses are worth debating further, as they raise several important issues with regard to research ethics, having an open debate and publishing scientific findings. Conclusion: The responses to the Shaken Baby Syndrome report indicate that scientific scrutiny risks being lost when researchers and organisations are not open to challenging established ideas
Thomas W. Smith - One of the best experts on this subject based on the ideXlab platform.
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Optic Nerve Damage in Shaken Baby Syndrome
Archives of Pathology & Laboratory Medicine, 2000Co-Authors: Aaron M. Gleckman, Richard J. Evans, Michael D. Bell, Thomas W. SmithAbstract:Abstract Background.—Rapid acceleration-deceleration of an infant's head during intentional shaking should in theory exert stretch or shear forces upon the optic nerves sufficient to cause axonal injury. β-Amyloid precursor protein (β-APP) immunohistochemistry recently has been shown to be a highly effective method for identifying diffuse axonal injury in the brains of infants with Shaken Baby Syndrome. In this study, we investigated the utility of β-APP in identifying optic nerve damage in infants who have sustained fatal whiplash shaking. Materials and Methods.—β-Amyloid precursor protein immunohistochemistry was performed on formalin-fixed, paraffin-embedded sections of eyes (including optic disc and distal optic nerve) from infants less than 1 year of age with Shaken Baby Syndrome (5 cases), combined Shaken Baby Syndrome/blunt head trauma (3 cases), and “pure” blunt head trauma (1 case). Nontraumatic control cases included infants who died of suffocation (1 case), sudden infant death Syndrome (1 case)...
Andreas Eriksson - One of the best experts on this subject based on the ideXlab platform.
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Shaken Baby Syndrome and the risk of losing scientific scrutiny
Acta paediatrica (Oslo Norway : 1992), 2017Co-Authors: Måns Rosén, Niels Lynøe, Göran Elinder, Boubou Hallberg, Pia C. Sundgren, Andreas ErikssonAbstract:A systematic review of Shaken Baby Syndrome by the Swedish Agency for Health Technology Assessment and Assessment of Social Services generated numerous reactions from professional organisations, ev ...
