Ulus Travma Acil Cerrahi Derg. 2019; 25(5): 527-530 | DOI: 10.5505/tjtes.2018.57059

Kaza sonucu oluþmamýþ, yaralý bebekte tel taraflý iskemik retinopati ve iki taraflý subdural kanama: Bir oftalmolojik yaklaþým

Chye Li Ee¹, Azlindarita Aisyah Mohd Abdullah², Amir Samsudin¹, Nurliza Khaliddin^1
1Malaya Üniversitesi Týp Fakültesi, Göz Hastalýklarý Bölümü, Kuala Lumpur-Malezya
²Universiti Teknologi MARA Týp Fakültesi, Göz Hastalýklarý Bölümü, SG Buloh, Selangor-Malezya

Kaza sonucu oluþmayan yaralanma (KSOY) dünya ölçeðinde sýk görülmeyen bir sorun olup bebeklerde önemli morbidite ve mortaliteye yol açmaktadýr. Klinik öyküyle uyumlu olmayan retina veya subdural kanamalarýn veya ensefalopatinin varlýðý yüksek olasýlýkla KSOY’yi düþündürür. Bu çalýþmada acil servise çok hýzlý baþlangýçlý yinelenen generalize tonik-klonik nöbetlerle gelen üç aylýk bir bebeði raporluyoruz. Travma öyküsü veya dýþardan görünür belirti yoktu. Kýz bebekte iki taraflý subdural kanamalar ve atipik tek taraflý iskemik retinopati saptanmýþtýr. Retinal fotokoagülasyon uygulamasý sonucu vitröz ve retina kanamalarýnýn kaybolduðu görülmüþtür. Ancak bu gözde görme pek geri dönmemiþtir. Bulgular, intrakranyal kanama ve tek taraflý retina kanamalarý olan bebeklerde yüksek olasýlýkla KSOY’den kuþkulanýlmasý gerektiðini göstermiþtir.

Anahtar Kelimeler: Ýnfant, iskemik retinopati; kaza sonucu oluþmamýþ yaralanma; subdural kanama; tek taraflý retina kanamasý.

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Unilateral ischaemic retinopathy and bilateral subdural haemorrhage in an infant with non-accidental injury: An ophthalmological approach

Chye Li Ee¹, Azlindarita Aisyah Mohd Abdullah², Amir Samsudin¹, Nurliza Khaliddin^1
1Department of Ophthalmology, Malaya University Faculty of Medicine, Kuala Lumpur-Malaysia
²Department of Ophthalmology, Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh, Selangor-Malaysia

Non-accidental injury (NAI) is not an uncommon problem worldwide, which leads to significant morbidity and mortality in infants. The presence of retinal or subdural haemorrhages, or encephalopathy with injuries inconsistent with the clinical history is highly suggestive of NAI. In this study, we report on a case of a a 3-month-old infant who presented to the casualty department with a very sudden onset of recurrent generalised tonic-clonic seizures. There was no history of trauma or visible external signs. She was found to have bilateral subdural haemorrhages and atypical unilateral ischaemic retinopathy. Retinal photocoagulation was performed with subsequent resolution of vitreous and retinal haemorrhages. However, visual recovery in that eye remained poor. The findings showed that a high index of suspicion of NAI is required in infants with intracranial haemorrhage and unilateral retinal haemorrhages.

Keywords: Infant, ischaemic retinopathy; non-accidental injury; subdural haemorrhage; unilateral retinal haemorrhage.

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