Shaken baby syndrome represents a specific form of the Abused child syndrome. Injury usually concerns the baby's head and the brain and it is caused by thoughtless treatment accompanied by harsh shaking movements of the head and neck. It can cause a contusion of the cervical spinal hord, a rupture of the bridging veins, intracranial bleeding and a brain tissue impairment either due to the direct axonal damage, or namely by hypoxic-ischaemic insult. The development of the lesion can be fatal, or it can result in permanent impairment of the motor system, in mental or sensory deficits. Occurrence of the syndrome in the Czech Republic is not known, foreign data give 25 cases per 100000 children below one year of age. Injured babies represent over 1% of those hospitalised at paediatric units of intensive care and more than 10% of the death rate at those departments. Proved abuse has forensic consequences: however, convictive evidence can be difficult to obtain. Article gives a concrete case of a boy with the diagnose Shaken baby syndrome.

• MeSH
• kojenec MeSH
• lidé MeSH
• syndrom třeseného dítěte diagnóza   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE: To determine the efficacy of pars plana vitrectomy (PPV) in children with intraocular hemorrhage (IOH) secondary to Abusive head trauma (AHT). METHODS: A long-term retrospective analysis evaluating epidemiology, management, safety, anatomical and functional results of PPV for IOH in children with AHT at tertiary referral center for children in the Czech Republic from 2004 to 2017. RESULTS: 18 children were identified with IOH due to AHT during observation period of 14 years. Overall incidence of IOH related to AHT was 29.6/100 000, in children under 1 year 22.2/100 000, in children 1 to 5 years 7.4/100 000. Mean age at the time of diagnosis was 13.7 (SD±20.53) months, median 5 months. IOH resolved in 56% of children, 64% eyes, spontaneously. 44% children, 36% eyes, underwent PPV. PPV was performed 30.5 (SD±16.98) days after established diagnosis on average. Postoperatively, 80% of eyes had anatomical improvement, 20% eyes had preexisting irreversible changes in the posterior pole. Vision of 50% eyes improved after surgery, vision of 20% eyes remained poor, 30% of eyes was not possible to test due to severe neurological impairment. Mean observational period was 33.4 (SD±38.21) months. Mortality rate of AHT in our group was 17%, all victims were younger 4 months. CONCLUSIONS: PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia.

• Klíčová slova
• Abusive head trauma, intraocular hemorrhage, pars plana vitrectomy, retinal hemorrhage, shaken baby syndrome, vitreous hemorrhage,
• MeSH
• dítě MeSH
• kraniocerebrální traumata * chirurgie   MeSH
• lidé MeSH
• odchlípení sítnice * chirurgie   MeSH
• retrospektivní studie MeSH
• vitrektomie MeSH
• zraková ostrost MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH