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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Temporary brittle bone disease: association with intracranial bleeding
Colin R Paterson1, Elizabeth A Monk
1Temple Oxgates, Longforgan, Dundee DD2 5HS, UK. c.s.paterson@btinternet.com
Journal of Pediatric Endocrinology & Metabolism : JPEM
|February 16, 2013
Summary
This study suggests that subdural bleeding and multiple fractures in infants may stem from natural causes, not child abuse. Further research is needed to understand this temporary brittle bone disease pattern.
Area of Science:
- Pediatrics
- Genetics
- Forensic Medicine
Background:
- Infants presenting with subdural bleeding and multiple fractures often raise concerns of non-accidental trauma.
- Previous literature has described similar presentations as temporary brittle bone disease.
Purpose of the Study:
- To investigate the etiology of subdural bleeding and multiple fractures in infants.
- To differentiate between abuse-related injuries and potential natural causes for this clinical presentation.
Main Methods:
- Retrospective case series of 20 infants (1-6 months old) with subdural bleeding and unexplained fractures.
- Clinical evaluation for evidence of injury, birth-related bleeding, and parental joint hypermobility.
- Follow-up assessment for subsequent allegations of abuse.
Main Results:
- Child abuse was deemed unlikely due to lack of commensurate injury, fractures occurring in-hospital, symmetrical metaphyseal lesions, and birth-related bleeding histories.
- Parental joint hypermobility was noted in 8/20 children, suggesting a potential genetic predisposition.
- No subsequent abuse allegations were reported in 9 children returned to parents after a mean follow-up of 15.8 years.
Conclusions:
- The combination of subdural bleeding and multiple fractures in infants may result from natural disease processes.
- Hypermobility in parents may indicate a heritable condition mimicking abuse.
- Awareness of potential natural causes is crucial for accurate diagnosis and management.
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