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Intracranial haemorrhage complicating infection in infant masquerading as non-accidental injury - A case series

K L Chng1, M Umul Khairil Fatimah2, S Kunasilan3

  • 1Sultan Ahmad Shah Medical Centre @International Islamic University Malaysia, Forensic Department, Malaysia. chngkayly@gmail.com.

The Malaysian Journal of Pathology
|April 29, 2022
PubMed

Insights

Sudden infant death in a carer's home requires thorough forensic pathology. Non-traumatic intracranial hemorrhage, like subdural or subarachnoid hemorrhage, can occur due to infection, not just injury.

Area of Science:

  • Forensic Pathology
  • Pediatric Autopsy
  • Neuropathology

Background:

  • Sudden unexpected deaths in infants necessitate careful forensic evaluation.
  • Forensic pathologists face significant responsibility in analyzing cases for accurate conclusions.

Observation:

  • Two cases of infant death in a carer's home are presented.
  • Both infants presented with acute intracranial hemorrhage (subdural and subarachnoid) without external trauma.
  • Hemorrhages were associated with severe lung infections and multi-organism infections, one with possible liver disease.

Findings:

  • Acute Intracranial Hemorrhage (ICH), particularly Subdural Hemorrhage (SDH), is often linked to inflicted head trauma.
  • Non-traumatic or spontaneous ICH in infants, while rare, can result from underlying medical conditions like severe infections.
  • Autopsy findings and holistic case analysis are crucial for determining the significance of ICH.

Implications:

  • Misdiagnosing the cause of ICH in infants can have catastrophic consequences.
  • This study highlights the importance of considering non-traumatic causes of ICH in forensic pediatric cases.
  • Comprehensive autopsy and clinical correlation are vital to avoid misattributing injury in cases of spontaneous intracranial hemorrhage.
Abstract

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