Saccadic intrusions in pediatric non-accidental trauma

Purpose: To report a case of saccadic intrusions in a 9-month-old under the context of non-accidental trauma. Observations: A 9-month-old female presented with the eye finding of intermittent ocular flutter. Upon imaging for neuroblastoma, she was discovered to have bilateral supratentorial subdural hematomas with internal septations, moderate mass effect on adjacent cerebral parenchyma, pachymeningeal and tentorial enhancement, and cortical vein thrombosis. This constellation of findings was concerning for non-accidental trauma. Conclusions and importance: Although an extremely rare occurrence, ocular flutter may be a presenting sign in non-accidental trauma, and imaging should absolutely be considered under such circumstances.