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A lucid interval in a victim of abusive head trauma with multiple parenchymal lacerations

Cree Kachelski1, Kelsey Gavin2, Hayden Head3

  • 1Division of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Mayo Clinic Center for Safe and Healthy Children and Adolescents, Mayo Clinic, Rochester, MN, USA.

Journal of Forensic and Legal Medicine
|January 7, 2024
PubMed

Insights

Abusive head trauma (AHT) can cause parenchymal lacerations in infants. This case study describes a rare lucid interval preceding acute decompensation in an infant with AHT and brain lacerations.

Area of Science:

  • Pediatrics
  • Neurology
  • Forensic Pathology

Background:

  • Abusive head trauma (AHT) is a significant cause of mortality in infants.
  • Parenchymal lacerations, a severe form of AHT, typically manifest with immediate neurological deficits.
  • Published literature on AHT has documented lucid intervals, but not specifically in conjunction with parenchymal lacerations.

Observation:

  • A healthy 2-month-old infant presented with injuries consistent with AHT, including three instances of parenchymal lacerations.
  • The infant exhibited a 2.5-hour period of normal neurological status following the initial injury.
  • This lucid interval was followed by acute neurological decompensation.

Findings:

  • This case presents the first documented instance of a lucid interval in an infant diagnosed with abusive head trauma and parenchymal lacerations.
  • The findings challenge the typical presentation of acute neurological symptoms associated with parenchymal lacerations.

Implications:

  • The presence of a lucid interval in AHT with parenchymal lacerations may alter diagnostic and management strategies.
  • This case highlights the importance of considering AHT even in the absence of immediate, severe neurological signs.
  • Further research is warranted to understand the pathophysiology and clinical significance of lucid intervals in pediatric abusive head trauma.

Keywords:
Abusive head traumaLucid intervalParenchymal laceration

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