The optic nerve sheath hemorrhage is a non-specific finding in cases of suspected child abuse

Marc De Leeuw, Emile Beuls, Philippe G. Jorens, Paul Parizel, Werner Jacobs

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


In young infants, the triad consisting of acute encephalopathy, retinal hemorrhages, and a subdural hematoma is a nonspecific finding. It has traumatic and non-traumatic etiologies. The triad may be found among a vast spectrum of natural diseases. Optic nerve sheath hemorrhage in infants is typically detected at autopsy. It is a nonspecific finding that can be found in traumatic and non-traumatic etiologies. Neither the triad nor the ONSH are pathognomonic for an abusive head injury. Opposite to the triad, the spectrum of non-traumatic etiologies of ONSH is limited. In infants ONSH rarely occurs in spontaneous subarachnoidal hemorrhage or in infectious conditions. Our results show that the clinical significance of the optic nerve sheath hemorrhage in the forensic work-up of fatal cases of alleged abusive head injury is its limited differential diagnosis. Only after careful differential diagnosis ONSH may contribute to the diagnosis of AHT. However, the main limitation of our study is the sampling bias, as the eyes are usually removed when abusive head trauma is suspected.

Original languageEnglish
Pages (from-to)43-48
Number of pages6
JournalJournal of Forensic and Legal Medicine
Publication statusPublished - 1 Nov 2015
Externally publishedYes


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