• A 13-month-old child with the pathognomonic findings of the shaken baby syndrome died secondary to cerebellar herniation. Pathologic examination disclosed extensive intraocular, optic nerve sheath, and intracranial hemorrhages, despite a paucity of external signs of trauma. Many of the hemorrhages were old, suggesting that the child had experienced multiple episodes of trauma. Hemorrhages of the optic nerve sheaths have not been previously reported with the shaken baby syndrome but probably accompany this condition frequently. Our patient's ocular hemorrhages may have resulted from a sudden rise in intracranial pressure.
Lambert SR, Johnson TE, Hoyt CS. Optic Nerve Sheath and Retinal Hemorrhages Associated With the Shaken Baby Syndrome. Arch Ophthalmol. 1986;104(10):1509-1512. doi:10.1001/archopht.1986.01050220103037