Fatal pediatric collapse with bilateral subdural hematoma and retinal hemorrhage occurring in a public park: a...

We report the death of a one-month-old infant who developed sudden neurological collapse in a public park and was later found to have bilateral subdural hematomas, extensive retinal hemorrhages, hypoxic-ischemic encephalopathy, and cerebral venous sinus thrombosis. No external or internal traumatic injuries were identified at autopsy, and the death was certified as natural. The public park setting was important because the same intracranial and ocular findings, if arising in a private setting without witnesses, might have prompted suspicion of abusive head trauma. This case illustrates the forensic importance of considering medical causes, including cerebral venous sinus thrombosis, in infants with subdural and retinal hemorrhages, and of avoiding diagnostic conclusions based primarily on the absence of an adequate caregiver explanation.