Delayed Sudden Death in an Infant Following an Accidental Fall

A Case Report with Review of the Literature

Scott Denton, Darinka Mileusnic

Research output: Contribution to journalReview article

35 Citations (Scopus)

Abstract

Several controversies exist regarding ultimately lethal head injuries in small children. Death from short falls, timing of head injury, lucid intervals, presence of diffuse axonal injury (DAI), and subdural hematoma (SDH) as marker of DAI are the most recent controversial topics of debate in this evolving field of study. In this area of debate, we present a case of delayed death from a witnessed all backwards off a bed in a 9-month-old black male child who truck his head on a concrete floor and was independently witnessed as "healthy" postfall for 72 hours until he was discovered dead in bed. Grandmother, babysitter, and mother all independently corroborated under police investigation that the child "acted and behaved normally" after the fall until death. Autopsy showed a linear nondisplaced parietal skull fracture, diastasis of adjacent occipital suture, subgaleal hemorrhage with evidence of aging, small posterior clotting SDH, marked cerebral edema, and a small tear of the midsuperior body of the corpus callosum consistent with focal axonal injury (FAI). No DAI was seen, and there were no retinal hemorrhages. All other causes of death were excluded upon thorough police and medical examiner investigation. Although this seems to be a rare phenomenon, a delayed, seemingly symptom-free interval can occur between a clinically apparent mild head injury and accidental death in a young child.

Original languageEnglish (US)
Pages (from-to)371-376
Number of pages6
JournalAmerican Journal of Forensic Medicine and Pathology
Volume24
Issue number4
DOIs
StatePublished - Dec 1 2003

Fingerprint

Accidental Falls
Sudden Infant Death
Diffuse Axonal Injury
Craniocerebral Trauma
Subdural Hematoma
Police
Retinal Hemorrhage
Skull Fractures
Coroners and Medical Examiners
Corpus Callosum
Brain Edema
Motor Vehicles
Tears
Sutures
Cause of Death
Autopsy
Head
Mothers
Hemorrhage
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Delayed Sudden Death in an Infant Following an Accidental Fall : A Case Report with Review of the Literature. / Denton, Scott; Mileusnic, Darinka.

In: American Journal of Forensic Medicine and Pathology, Vol. 24, No. 4, 01.12.2003, p. 371-376.

Research output: Contribution to journalReview article

@article{f611ed2d43c44c7db59a1cbb4784e21c,
title = "Delayed Sudden Death in an Infant Following an Accidental Fall: A Case Report with Review of the Literature",
abstract = "Several controversies exist regarding ultimately lethal head injuries in small children. Death from short falls, timing of head injury, lucid intervals, presence of diffuse axonal injury (DAI), and subdural hematoma (SDH) as marker of DAI are the most recent controversial topics of debate in this evolving field of study. In this area of debate, we present a case of delayed death from a witnessed all backwards off a bed in a 9-month-old black male child who truck his head on a concrete floor and was independently witnessed as {"}healthy{"} postfall for 72 hours until he was discovered dead in bed. Grandmother, babysitter, and mother all independently corroborated under police investigation that the child {"}acted and behaved normally{"} after the fall until death. Autopsy showed a linear nondisplaced parietal skull fracture, diastasis of adjacent occipital suture, subgaleal hemorrhage with evidence of aging, small posterior clotting SDH, marked cerebral edema, and a small tear of the midsuperior body of the corpus callosum consistent with focal axonal injury (FAI). No DAI was seen, and there were no retinal hemorrhages. All other causes of death were excluded upon thorough police and medical examiner investigation. Although this seems to be a rare phenomenon, a delayed, seemingly symptom-free interval can occur between a clinically apparent mild head injury and accidental death in a young child.",
author = "Scott Denton and Darinka Mileusnic",
year = "2003",
month = "12",
day = "1",
doi = "10.1097/01.paf.0000097851.18478.16",
language = "English (US)",
volume = "24",
pages = "371--376",
journal = "American Journal of Forensic Medicine and Pathology",
issn = "0195-7910",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Delayed Sudden Death in an Infant Following an Accidental Fall

T2 - A Case Report with Review of the Literature

AU - Denton, Scott

AU - Mileusnic, Darinka

PY - 2003/12/1

Y1 - 2003/12/1

N2 - Several controversies exist regarding ultimately lethal head injuries in small children. Death from short falls, timing of head injury, lucid intervals, presence of diffuse axonal injury (DAI), and subdural hematoma (SDH) as marker of DAI are the most recent controversial topics of debate in this evolving field of study. In this area of debate, we present a case of delayed death from a witnessed all backwards off a bed in a 9-month-old black male child who truck his head on a concrete floor and was independently witnessed as "healthy" postfall for 72 hours until he was discovered dead in bed. Grandmother, babysitter, and mother all independently corroborated under police investigation that the child "acted and behaved normally" after the fall until death. Autopsy showed a linear nondisplaced parietal skull fracture, diastasis of adjacent occipital suture, subgaleal hemorrhage with evidence of aging, small posterior clotting SDH, marked cerebral edema, and a small tear of the midsuperior body of the corpus callosum consistent with focal axonal injury (FAI). No DAI was seen, and there were no retinal hemorrhages. All other causes of death were excluded upon thorough police and medical examiner investigation. Although this seems to be a rare phenomenon, a delayed, seemingly symptom-free interval can occur between a clinically apparent mild head injury and accidental death in a young child.

AB - Several controversies exist regarding ultimately lethal head injuries in small children. Death from short falls, timing of head injury, lucid intervals, presence of diffuse axonal injury (DAI), and subdural hematoma (SDH) as marker of DAI are the most recent controversial topics of debate in this evolving field of study. In this area of debate, we present a case of delayed death from a witnessed all backwards off a bed in a 9-month-old black male child who truck his head on a concrete floor and was independently witnessed as "healthy" postfall for 72 hours until he was discovered dead in bed. Grandmother, babysitter, and mother all independently corroborated under police investigation that the child "acted and behaved normally" after the fall until death. Autopsy showed a linear nondisplaced parietal skull fracture, diastasis of adjacent occipital suture, subgaleal hemorrhage with evidence of aging, small posterior clotting SDH, marked cerebral edema, and a small tear of the midsuperior body of the corpus callosum consistent with focal axonal injury (FAI). No DAI was seen, and there were no retinal hemorrhages. All other causes of death were excluded upon thorough police and medical examiner investigation. Although this seems to be a rare phenomenon, a delayed, seemingly symptom-free interval can occur between a clinically apparent mild head injury and accidental death in a young child.

UR - http://www.scopus.com/inward/record.url?scp=0344443815&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344443815&partnerID=8YFLogxK

U2 - 10.1097/01.paf.0000097851.18478.16

DO - 10.1097/01.paf.0000097851.18478.16

M3 - Review article

VL - 24

SP - 371

EP - 376

JO - American Journal of Forensic Medicine and Pathology

JF - American Journal of Forensic Medicine and Pathology

SN - 0195-7910

IS - 4

ER -