|Retinal fold with hemorrhage|
Thursday, January 13, 2011
Retinal changes in inflicted pediatric head trauma
The illustrious Peter Cummings, MD recently contributed an excellent post to the Cambridge University Press medical blog on the topic inflicted pediatric head trauma. In particular, Dr. Cummings discusses the presence of retinal hemorrhage and retinal hemorrhage as evidence for pediatric head trauma. Whether or not the trauma had been intentionally inflicted depends, of course, on the history provided by witnesses and law enforcement.as there are no pathognomonic findings. But, as Dr. Cummings says in his post: "I treat every pediatric case as though it is a homicide until I can prove to myself that it is not."
Given the near ubiquity of artefactual retinal folds in extracted eye specimens, I asked Dr. Cummings whether there is a role for postmortem funduscopic examination. He responded that he has had some success with this technique, but postmortem corneal clouding often makes funduscopic exams impossible.
Dr. Cummings is the director of forensic neuropathology at the Office of the Chief Medical Examiner in Boston, Massachusetts. He is also first editor of Atlas of Forensic Histopathology, which has just been released by Cambridge University Press.