Histological dating of subarachnoid hemorrhage and retinal hemorrhage in infants. (October 2019)

• Record Type: Journal Article
• Authors: Delteil, Clémence; Kolopp, Martin; Capuani, Caroline; Humez, Sarah; Boucekine, Mohamed; Leonetti, Georges; Torrents, Julia; Tuchtan, Lucile; Piercecchi, Marie-Dominique
• Is Part Of: Forensic science international. Volume 303(2019)
• Publication Date: 2019-10
• Subjects: AHT abusive head trauma -- PTI posttraumatic interval -- SAH sub arachno id hemorrhage -- SDH subdural hematoma -- RBCs red blood cells -- RH retinal hemorrhage -- PMNs polymorphonuclear neutrophils; Shaken baby syndrome -- Dating -- Histology -- Sub arachno id hemorrhage -- Retinal hemorrhage -- Age estimation -- Posttraumatic interval; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2019.109952
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: Dating the traumatic event is usually done on subdural hematoma. Dating on subarachnoid hemorrhage is also possible. Dating on retinal hemorrhage is not relevant enough. Abstract: Background: Dating the traumatic event is usually done on subdural hematoma (SDH). After infant deaths due to Abusive head trauma (AHT) without SDH available, the magistrates still ask experts to date the traumatic event. To do so, the expert only has tools based on adult series of AHT. We aimed to develop a subarachnoid hemorrhage (SAH) and retinal hemorrhage (RH) dating system applicable to infants aged under 3 years. Methods and results: We studied a retrospective multicenter collection of 235 infants who died between the ages of 0 and 36 months, diagnosed with SAH and/or RH by forensic pathological examination and with known posttraumatic interval (PTI). Two pathologists assessed blindly and independently 12 histomorphological features in 83 infants (35 girls, 48 boys) whose median age was 3.8 months. For SAH, histopathological changes were significantly correlated with PTI for the appearance of red blood cells, of fibrino-plaquetted organization, the quantity of lymphocytes and macrophages and the presence or absence of siderophages, collagen and fibroblast formation and presence or absence of neovascularization. For RH, histopathological changes were significantly correlated with PTI for the appearance of red blood cells, the presence or absence of siderophages and sclerosis of the retina. Conclusion: Our HAS dating system improves the precision and reliability of forensic pathological expert examination of AHT, when SDH are not available, for age estimation in infants. The study of RH histomorphological changes does not allow for reliable dating.