 |
|
Severe retinal hemorrhaging is linked to severe motor vehicle crashes
June 24, 2008The severity of retinal hemorrhaging for young children in motor vehicle crashes is closely correlated to the severity of the crash, according to a new study by researchers at the Medical College of Wisconsin in Milwaukee. Retinal hemorrhages occur when the blood vessels lining the retina rupture, resulting in bleeding onto the surface of the retina.
The study, by Jane Kivlin, M.D., and Kenneth Simons, M.D., professors of ophthalmology at the Medical College, is published in the June issue of Archives of Ophthalmology.
"The severity of the retinal injuries is similar to that seen in nonaccidental childhood neurotrauma, or shaken baby syndrome," according to Dr. Kivlin, a pediatric ophthalmologist and lead author, who sees patients at Children's Hospital of Wisconsin. "Many perpetrators of shaken baby syndrome have confessed to violently shaking the child, subjecting the child to severe rotational force."
The retrospective study examined ten cases of children younger than three years taken from autopsies performed by the Milwaukee County medical examiner from January 1, 1994, to December 31, 2002. All patients died in motor vehicle crashes as passengers or pedestrians. They were subjected to extremely severe forces involving rapid deceleration with a rotational, or whiplash-like, component.
For each case, all available medical and autopsy records, including pathology slides, photographs, and police and traffic department records, were reviewed. All patients suffered severe head injuries in the accidents. Skull fractures were found in all but three patients. In six patients, improper restraints and direct blows were found to contribute to their injuries.
"These were all extremely high-force injury mechanisms that far exceed those involved in common or even uncommon household accidents," says Dr. Kivlin.
Of the ten cases, extensive retinal hemorrhages were found in eight patients, similar to the severe hemorrhages seen in shaken baby syndrome. Two patients had no signs of retinal hemorrhaging, but nine of the ten patients were found to have optic nerve sheath hemorrhages, which are also commonly found in shaken babies.
"Hemorrhages of this degree have rarely been reported in accidental trauma, even with skull fractures. But most of the reported patients did not die of their trauma. So we conclude that severe hemorrhages reflect severe trauma," says Dr. Kivlin.
"The association of extensive, sometimes severe, ocular hemorrhages with fatal accidental trauma, compared with previous reports of accidental trauma with no or few hemorrhages, indicates the severity of injury required to cause hemorrhages of this magnitude."
Medical College of Wisconsin
The retrospective study examined ten cases of children younger than three years taken from autopsies performed by the Milwaukee County medical examiner from January 1, 1994, to December 31, 2002. All patients died in motor vehicle crashes as passengers or pedestrians. They were subjected to extremely severe forces involving rapid deceleration with a rotational, or whiplash-like, component.
For each case, all available medical and autopsy records, including pathology slides, photographs, and police and traffic department records, were reviewed. All patients suffered severe head injuries in the accidents. Skull fractures were found in all but three patients. In six patients, improper restraints and direct blows were found to contribute to their injuries.
"These were all extremely high-force injury mechanisms that far exceed those involved in common or even uncommon household accidents," says Dr. Kivlin.
Of the ten cases, extensive retinal hemorrhages were found in eight patients, similar to the severe hemorrhages seen in shaken baby syndrome. Two patients had no signs of retinal hemorrhaging, but nine of the ten patients were found to have optic nerve sheath hemorrhages, which are also commonly found in shaken babies.
"Hemorrhages of this degree have rarely been reported in accidental trauma, even with skull fractures. But most of the reported patients did not die of their trauma. So we conclude that severe hemorrhages reflect severe trauma," says Dr. Kivlin.
"The association of extensive, sometimes severe, ocular hemorrhages with fatal accidental trauma, compared with previous reports of accidental trauma with no or few hemorrhages, indicates the severity of injury required to cause hemorrhages of this magnitude."
Medical College of Wisconsin
Hemorrhage Current Events and Hemorrhage News RSSTreatment window expanded
Patients can still benefit up to 4.5 hours after a stroke if a drug that dis-solves blood clots in the brain is administered. Thus far, three hours had been considered the useful limit for administering thrombolytic drugs.
Blood thinning drug linked to increased bleeding in brain
A new study shows that people who take the commonly used blood thinning drug warfarin may have larger amounts of bleeding in the brain and increased risk of death if they suffer a hemorrhagic stroke.
A new breakthrough in timing of urgent endoscopy for gastrointestinal bleeding patients
It is widely accepted that urgent endoscopy for UGIB should be performed within 24 hour from the admission. However, within this period of time, it is still unclear whether it should be performed either very early - i.e. within 2 hour - or in a more delayed interval, such as after 6, 12 or 24 hour.
Women may stop anticoagulants after blood clots
Women may safely discontinue oral anticoagulants (blood thinners) after 6 months of treatment following a first unprovoked venous blood clot (thromboembolism) if they have no or one risk factor.
Study examines association of smoking with hemorrhage after throat surgery
Smoking appears to be associated with an increased rate of hemorrhage (bleeding) in patients who undergo uvulopalatopharyngoplasty (UPPP, a surgical procedure used to remove excess tissue from the throat) with tonsillectomy (a surgical procedure in which the tonsils are removed), but not in those who undergo tonsillectomy alone.
Telemedicine leads to better stroke treatment decisions
Researchers at the University of California, San Diego Medical Center say that their first-of-its-kind study of a telemedicine program which transports stroke specialists via computer desktop or even laptop to the patient's bedside, using highly sophisticated video, audio and Internet technology, could have an immediate and profound impact on the treatment of stroke patients throughout the world.
Maternal deaths following cesarean delivery can be reduced
Maternal death rates have remained constant in the United States for many decades. Are there any improvements in health care that could reduce these rates further?
Statins have unexpected effect on pool of powerful brain cells
Cholesterol-lowering drugs known as statins have a profound effect on an elite group of cells important to brain health as we age, scientists at the University of Rochester Medical Center have found. The new findings shed light on a long-debated potential role for statins in the area of dementia.
'Hibernation-on-demand' drug significantly improves survival after extreme blood loss
For the first time, researchers have demonstrated that the administration of minute amounts of inhaled or intravenous hydrogen sulfide, or H2S - the molecule that gives rotten eggs their sulfurous stench - significantly improves survival from extreme blood loss in rats.
Pharmaceutical study: Less hemorrhaging after stroke, but not fewer deaths
An international study published in May 2008 in the "New England Journal of Medicine" has shown that the coagulation factor VIIa can limit the extent of a cerebral hemorrhage. However, in the long term it does not prevent death or severe impairment.
More Hemorrhage Current Events and Hemorrhage News Articles
| Cracking Up: Nice Day for a Brain Hemorrhage by Peter Swet | |
| Cerebral Hemorrhage from Venous and Capillary Stasis by Stanley Cobb | |
| Post-Traumatic Pulmonary Insufficiency: Pathophysiology of Respiratory Failure and Principles of Respiratory Care After Surgical Operations, Trauma, Hemorrhage, Burns, and Shock by Francis D.; Lyons, Jr., John H.; Pierce, Jr.; Ellison C.; Morgan, Jr., Alfred P.; Drinker, Philip A. and Gustave Dammin. Moore | |
 | Birth Emergency Skills Training: Manual for Out -of- Hospital Midwives by Bonnie U. Gruenberg Midwives attending childbirth in homes and birth centers seldom encounter emergencies, but when crisis occurs, lives hang in the balance! It is difficult to remain proficient in skills so seldom practiced, yet pregnant women rely on the expertise of the provider in an emergency. Birth Emergency Skills Training: Manual for Out-of-Hospital Midwives is the interface between the world of midwifery... |
| Intracerebral Hemorrhage by Carlos S. Kase, Louis R. Caplan Boston University, Massachusetts. Reference for neurologists on adult intracerebral hemorrhage. Discusses clinical, pathological, and radiologic findings, mechanisms, location, and treatment of hemorrhage. Illustrated. 7 U.S. contributors. DNLM: Cerebral... | |
| Gastrointestinal hemorrhage | |
| Amiodarone-induced pulmonary hemorrhage.(Editorial) : An article from: Southern Medical Journal by Sonal Singh This digital document is an article from Southern Medical Journal, published by Southern Medical Association on April 1, 2006. The length of the article is 1388 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.Citation... | |
| Subarachnoid hemorrhage and cerebrovascular spasm | |
| Gastrointestinal Hemorrhage (Clinical Surgery International) | |
| Blood transfusion, hemorrhage and the anaemias by Bertram Moses Bernheim |
| © 2008 BrightSurf.com |