Skull fractures and hyperacute subdural hemorrhage child abuse

Case contributed by Dr Joseph Scheller

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
  • skull fractures left and right parietal, left occipital. 
  • scalp swelling right frontal and parietal and left parietal.
  • right hemisphere acute subdural haemorrhage with right to left shift, hemispheric oedema, 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.

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Case information

rID: 56556
Case created: 8th Nov 2017
Last edited: 19th Nov 2017
Inclusion in quiz mode: Included

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