{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T15:54:45Z","timestamp":1778169285956,"version":"3.51.4"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Increased intracranial pressure (ICP) has been suggested in legal settings as an alternative cause of retinal hemorrhages (RHs) in young children who may have sustained abusive head trauma. We assessed the prevalence and characteristics of RHs in children with increased ICP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We conducted a prospective, multicenter study of children &amp;lt;4 years old with newly diagnosed increased ICP as determined by using direct measurement and\/or clinical criteria. Infants who were premature, neonates, and suspected survivors of abusive head trauma were excluded on the basis of nonocular findings. Fundus examinations were performed; extent, number, and type of RH in each of 4 distinct retinal zones were recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Fifty-six children (27 boys) were studied (mean age 15.4 months; range 1\u201343 months). All of the children had elevated ICP that required intervention. One child had papilledema. No child (0%; 95% confidence interval: 0%\u20136.4%) or eye (0%; 95% confidence interval: 0%\u20133.3%) was found to have an RH. Causes of increased ICP included hydrocephalus, intraventricular hemorrhage, congenital malformations, malfunctioning shunts, and the presence of intracranial space-occupying lesions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Although acute increased ICP can present in children with a pattern of peripapillary superficial RHs in the presence of papilledema, our study supports the conclusion that RHs rarely occur in the absence of optic disc swelling and do not present beyond the peripapillary area in the entities we have studied.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2018-1182","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T13:25:13Z","timestamp":1547126713000},"source":"Crossref","is-referenced-by-count":17,"title":["Retinal Findings in Young Children With Increased Intracranial Pressure From Nontraumatic Causes"],"prefix":"10.1542","volume":"143","author":[{"given":"Angell","family":"Shi","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhaya","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth W.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avery","family":"Weiss","sequence":"additional","affiliation":[{"name":"Ophthalmology, Seattle Children\u2019s Hospital and School of Medicine, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily A.","family":"McCourt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Children\u2019s Hospital Colorado and School of Medicine, University of Colorado, Aurora, Colorado;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Schloff","sequence":"additional","affiliation":[{"name":"Associated Eye Care, St Paul, Minnesota;"},{"name":"Department of Ophthalmology and Visual Neurosciences, Children\u2019s Minnesota St Paul Hospital, St Paul, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Partington","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gillette Children\u2019s Specialty Healthcare, St Paul, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Forbes","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke E.","family":"Geddie","sequence":"additional","affiliation":[{"name":"Division of Pediatric Ophthalmology, Helen DeVos Children\u2019s Hospital, Grand Rapids, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Bierbrauer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul H.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas;"},{"name":"Department of Ophthalmology, Arkansas Children\u2019s Hospital, Little Rock, Arkansas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nationwide Children\u2019s Hospital, Columbus, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Abed Alnabi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania; and"},{"name":"M\u00e9decins Sans Frontieres, Amman, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gil","family":"Binenbaum","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex V.","family":"Levin","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania;"},{"name":"Department of Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"issue":"2","key":"2021121013210590700_B1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2013-0262","article-title":"Patterns of retinal hemorrhage associated with increased intracranial pressure in children.","volume":"132","author":"Binenbaum","year":"2013","journal-title":"Pediatrics"},{"issue":"7","key":"2021121013210590700_B2","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1001\/archpediatrics.2012.46","article-title":"Retinal hemorrhages in children: the role of intracranial pressure.","volume":"166","author":"Shiau","year":"2012","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"2","key":"2021121013210590700_B3","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3171\/jns.1974.41.2.0160","article-title":"Intraocular and optic nerve sheath hemorrhage in cases of sudden 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