Death of an infant

0y · Male·Traumatic head injuries including subdural haemorrhage, intracranial haemorrhage, ischaemic necrosis of the brain, cerebral oedema and axonal injury

A seven-week-old infant died from traumatic head injuries including subdural haemorrhage, retinal haemorrhages, and axonal injury. Medical evidence established two separate traumatic brain injuries occurring approximately one month apart, with the final injury likely occurring on the day of hospital admission. Multiple rib fractures were also identified at autopsy. All treating medical experts rejected proposed accidental explanations (a toddler's fall with a plastic pot, an older sibling falling on the infant) as inconsistent with the injury pattern. The clinical lesson is that the classic triad of subdural haemorrhage, retinal haemorrhage, and encephalopathy in an infant should raise immediate concern for non-accidental injury. Early recognition of inconsistencies between history and injuries, and appropriate notification of child protection authorities, is critical. The coroner could not determine who inflicted the injuries or precisely when, though evidence suggested possible vigorous shaking.