Retinal hemorrhage means bleeding onto the surface of the retina caused by rupture of the tiny blood vessels that lie on the surface of the retina. Retinal hemorrhage signify increased pressure within the skull. This may result from head trauma and bleeding, whether accidental or intentional (child abuse). It was once believed to be pathognomonic of so-called shaken baby syndrome, but this is no longer thought to be true by the forensic pathology community. Retinal hemorrhages in children are important clinical findings. They may be associated with trauma or systemic diseases. In the absence of bleeding disorders, retinal hemorrhage most often result from non - accidental injuries such as direct streaking of the head, severe shaking causing acceleration - deceleration and thoracic compressions.



Hemorrhages in the retina have many causes (including diabetic retinopathy,hypertensive retinopathy, physical trauma, bleeding diathesis and increased intracranial pressure). Sever contraction of chest muscles in convulsion, crying or vomiting may cause retinal hemorrhages. Retinal hemorrhages occur when blood extravasates from blood vessells due to variety of causes from benign to life - threatening conditions. It is usually seen in children with trauma (including child abuse), vomiting, coughing or cardiopulmonary resucitation. Theoretical mechanism is sudden rise of retinal venous pressure secondary to forceful thoracoabdominal muscle contraction. Such a mechanism is also possible after convulsion. There are a number of reports in literature about retinal hemorrhages after convulsion.