Histological dating of subarachnoid hemorrhage and retinal hemorrhage in infants.
Blood Platelets
/ pathology
Child Abuse
Child, Preschool
Collagen
/ metabolism
Erythrocytes
/ pathology
Female
Fibrin
/ metabolism
Fibroblasts
/ pathology
Forensic Pathology
Humans
Infant
Infant, Newborn
Lymphocytes
/ pathology
Macrophages
/ pathology
Male
Neovascularization, Physiologic
Postmortem Changes
Retina
/ pathology
Retinal Hemorrhage
/ pathology
Retrospective Studies
Sclerosis
/ pathology
Subarachnoid Hemorrhage
/ pathology
Age estimation
Dating
Histology
Posttraumatic interval
Retinal hemorrhage
Shaken baby syndrome
Sub arachno id hemorrhage
Journal
Forensic science international
ISSN: 1872-6283
Titre abrégé: Forensic Sci Int
Pays: Ireland
ID NLM: 7902034
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
29
05
2019
revised:
22
07
2019
accepted:
26
08
2019
pubmed:
24
9
2019
medline:
20
12
2019
entrez:
24
9
2019
Statut:
ppublish
Résumé
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. 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 12histomorphological 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. 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.
Sections du résumé
BACKGROUND
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
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 12histomorphological 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
CONCLUSIONS
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.
Identifiants
pubmed: 31546166
pii: S0379-0738(19)30364-0
doi: 10.1016/j.forsciint.2019.109952
pii:
doi:
Substances chimiques
Fibrin
9001-31-4
Collagen
9007-34-5
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
109952Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.