Are retinal haemorrhages secondary to intracranial bleeding?
Since retinal haemorrhages frequently coexist with subdural haemorrhages in severely damaged children,26 the question often asked is did the same traumatic event cause bleeding in both sites, or did the retinal haemorrhages develop secondary to the intracranial bleeding.Terson syndrome27 describes ocular haemorrhage in association with subarachnoid haemorrhage, but is now expanded to include intraocular bleeding associated with any form of intracranial bleeding. It affects between 16 and 27% of adult patients.28, 29 Schloff et al30 investigated, prospectively, 57 children aged 5 months–16.1 years (mean age 10.3 years), seen with intracranial bleeding. In total, 26 of the children had undergone neurosurgery, and 27 were the victims of trauma. Of the total group, 96% (55 children) showed no evidence of intraocular bleeding, despite 18% having papilloedema. Of the two children with intraocular bleeding, one 7-year-old child had three superficial retinal haemorrhages following a road traff
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