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Multicystic encephalomalacia as an end-stage finding in abusive head trauma

S E Matlung1, R A C Bilo, B Kubat

  • 1Faculty of Science, University of Amsterdam, Amsterdam, The Netherlands.

Forensic Science, Medicine, and Pathology
|April 27, 2011
PubMed

Insights

Abusive head trauma (AHT) can lead to multicystic encephalomalacia (MCE) in infants. This study confirms MCE as a severe outcome of AHT, even from shaking alone, with poor neurological prognosis.

Area of Science:

  • Forensic Pathology
  • Pediatric Neurology
  • Child Abuse Research

Background:

  • Abusive head trauma (AHT) is a severe form of child abuse with potentially devastating neurological outcomes.
  • Multicystic encephalomalacia (MCE) has been observed in infants following severe AHT.
  • This study investigates the occurrence and characteristics of MCE in infants subjected to AHT.

Observation:

  • A review of the Netherlands Forensic Institute database identified five cases of AHT in infants under one year old between 1999 and 2010.
  • The infants, aged 8 to 142 days, developed cystic encephalomalacia following inflicted traumatic brain injury.
  • Survival times varied from 27 to 993 days, with all cases confirmed by autopsy.

Findings:

  • All five cases involved proven child abuse, with judicial autopsy confirming MCE.
  • In two instances, the perpetrator confessed solely to shaking the infant.
  • This report highlights MCE as a significant, though infrequently documented, consequence of AHT.

Implications:

  • Confirms MCE as a pathological outcome of AHT, even in cases involving only shaking.
  • Underscores the critical importance of forensic investigation in identifying AHT and its sequelae.
  • Emphasizes the severe neurological damage and poor prognosis associated with AHT in infants.

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