Persistent Retinal Iron in Abusive Head Trauma

Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5‐month‐old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas...

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Bibliographic Details
Published in:Journal of forensic sciences 2016-11, Vol.61 (6), p.1693-1696
Main Authors: Bais, Babette, Karst, Wouter A., Kubat, Bela, Verdijk, Robert M.
Format: Article
Language:English
Subjects:
abusive head trauma
child abuse
Children & youth
Forensic pathology
forensic science
Head injuries
Hemorrhage
hemosiderin
long‐term survivor
ophthalmic pathology
pathology
Retina
retinal hemorrhages
shaken baby syndrome
Trauma
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Summary:Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5‐month‐old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas, and retinal hemorrhages consistent with abusive head trauma (AHT). At the age of 3, he was readmitted to hospital with spontaneous osteopenic fracture of the right femur. The patient deteriorated and died after unsuccessful resuscitation. Ophthalmopathological investigation showed atrophy of the retina and optic nerve and hemosiderin deposition in both eyes. Retinal hemosiderin deposition is currently generally assumed to disappear within 6–8 weeks after the occurrence of hemorrhage in AHT. This case report describes an infant with bilateral retinal hemosiderin depositions due to hemorrhages sustained from AHT occurring 32 months prior to death. Implications of this finding for the interpretation of retinal hemosiderin depositions in AHT are discussed.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.13215