Do high cervical injuries from any other source give rise to retinal haemorrhages?
In a study of the vegetative reactions of infants undergoing cervical manipulation12 apnoea occurred in 22. 1% of 199 children. This may be pertinent to the SBS, but no child progressed to the cascade of neurological sequelae associated with SBS. There seems no reason to believe that apnoea from cervical injury alone is sufficient to replicate the clinical picture of SBS. A group of children13 with a mean age of 6.3 years presented with multiple injuries and cardio-respiratory collapse, which could not be explained by blood loss. Of the 19 children, 18 died, and post mortem studies in 16 showed significant cord laceration (up to transection) in 13. Neither subdural nor retinal haemorrhages were commented on in this report.Conclusion: Cervical injuries alone do not give rise to retinal bleeding. However, cervical injuries in small children may produce apnoea. Inflicted cervical spine injury coupled with circulatory collapse has the potential to induce hypoxic/ischaemic encephalopathy.
