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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Subdural hemorrhages and severe retinal hemorrhages in a short fall with a rotational component

Aisling R Geoghegan1, Michelle Shouldice1, Kamiar Mireskandari2

  • 1Department of Pediatrics, University of Toronto, Toronto, Canada; The Hospital for Sick Children, Toronto, Canada.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|June 12, 2023
PubMed

Insights

A 5-month-old infant experienced subdural and retinal hemorrhages after a short fall. Increased rotational and deceleration forces may have contributed, challenging typical injury assumptions from household falls.

Area of Science:

  • Pediatric medicine
  • Forensic pathology
  • Biomechanics

Background:

  • Child abuse investigations often rely on injury patterns.
  • Understanding injury mechanisms in infants is crucial for accurate diagnosis.
  • Short falls are generally considered low-impact events.

Observation:

  • A 5-month-old infant presented with subdural and extensive retinal hemorrhages.
  • Video footage showed the infant falling from a swivel chair.
  • The fall appeared to be a short-distance household fall.

Findings:

  • The observed hemorrhages are inconsistent with typical injuries from short household falls.
  • Analysis of the fall dynamics suggested increased rotational and deceleration forces.
  • These forces may be a critical factor in generating severe intracranial and ocular injuries.

Implications:

  • This case highlights the potential for severe injury from seemingly minor falls in infants.
  • It underscores the importance of considering biomechanical factors beyond fall height.
  • Forensic analysis of fall dynamics can aid in differentiating accidental injuries from abuse.

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