Journal international de pathologie ophtalmique

Extramedullary Hematopoiesis in Abusive Head Trauma

Robert M Verdijk

was observed in an otherwise clear cut case of abusive head trauma with bilateral retinal hemorrhage, optic nerve sheath hemorrhage and peripapillary intrascleral hemorrhage. Review of 60 archival cases of suspected abusive head trauma identified two more examples of extramedullary hematopoiesis in abusive head trauma that initially had been diagnosed as uveitis. Extramedullary hematopoiesis of the choroid may have a relation to premature birth, possible anemia or may be a reaction to intraocular bleeding due to earlier trauma. Choroidal extramedullary hematopoiesis may easily be confused for choroiditis and interpreted as a sign of infectious disease. Awarenes of the possibiliy of extramedullary hematopoiesis of the choroid should prevent misdiagnosis.