NCJ Number
197466
Journal
Child Maltreatment Volume: 7 Issue: 4 Dated: November 2002 Pages: 329-348
Editor(s)
Mark Chaffin
Date Published
November 2002
Length
20 pages
Annotation
Through addressing various forensic controversies, this article explores how to objectively interpret the forensic significance of pediatric intracranial hemorrhage or rebleeding in suspected victims of abusive head trauma.
Abstract
Abusive head trauma is the leading cause of traumatic death during infancy. An in-depth understanding of the pathogenesis of posttraumatic subdural and subarachnoid collections is required to determine objectively that an infant’s intracranial hemorrhage or rebleeding resulted from inflicted injury or re-injury. To objectively interpret the forensic significance of pediatric intracranial hemorrhage or rebleeding, this article explores the following eight questions: (1) what are the potential explanations for enlargement of the subarachnoid space in an infant or young child; (2) is an infant or young child with an enlarged subarachnoid space predisposed to subdural bleeding; (3) what is the differential diagnosis for subdural hematoma; (4) what is the pathophysiology of traumatic subdural hemorrhage; (5) what does serial cranial imaging reveal in young victims of head trauma; (6) what are the potential explanations for heterogeneity in the appearance of a subdural collection on CT or MR imaging; (7) under what circumstances do subdural hemorrhages rebleed; and (8) what are the expected clinical consequences of traumatic subdural bleeding and rebleeding in an infant or young child? Concluding that an infant’s intracranial hemorrhage or rebleeding resulted from inflicted cranial injury or re-injury may have serious forensic consequences. Tables and references