Four intracranial injury cases with peripapillary scleral hemorrhage-Reconsidering the mechanism of hemorrhage

- Peripapillary scleral hemorrhage is reported in shaken baby syndrome cases.
- The back of the head was the main impact site in cases we studied.
- The hemorrhage source was arterial vessels at the Zinn-Haller arterial ring.
- It is caused by optic nerve traction due to linear acceleration or violent shaking.
- Peripapillary scleral hemorrhage is a reliable finding of head acceleration injury.