The hemorrhages can be unilateral. Although retinal hemorrhages are highly associated with the diagnosis of child abuse, they are not diagnostic by themselves. Infants examined after delivery can often have some retinal hemorrhages, but these will usually resolve within 1 month of life. Rarely has cardiopulmonary resuscitation been documented to cause retinal hemorrhages. However, when retinal folds and tears are present and associated with hemorrhage, it is much more specific to trauma and abuse.
Radiographs are an essential part of the evaluation.
These are subtle findings that must be searched for and if found require additional investigation. On occasion, the plain radiographs raise a question of an injury and subsequent nuclear bone scanning or delayed repeat radiographs are necessary. Note that skull radiographs are superior to Computed Tomography scans in the detection of skull fractures. CT is the primary test for evaluating intracranial injury. This includes subdural hematomas and subarachnoid hemorrhage.