Presentation
Child unconscious while in care of Mom's boyfriend. EMS notes multiple bruises on the child's body.
Patient Data
Age: 8 months
Gender: Male
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- skull fractures left and right parietal, left occipital.
- scalp swelling right frontal and parietal and left parietal.
- right hemisphere acute subdural hemorrhage with right to left shift, hemispheric edema, and right uncal herniation.
Case Discussion
Mom and boyfriend both have a history of sociopathic behavior and drug use. Mom watches the child until 5pm, Dad until 7pm, 911 call is made at 7pm, EMS finds a comatose child with multiple bruises, Mom and boyfriend deny any trauma.
Radiology reports both parietal fractures, the occipital fracture is noted only at autopsy.
The child undergoes emergency and a 'hyperacute' subdural hematoma is evacuated by the neurosurgeon. The child dies the next day.