Abusive Head Trauma
“These images were originally published in the Retina Image Bank. Author. Photographer. Title. Retina Image Bank. Year; Image Number. © the American Society of Retina Specialists."
Initial scalp reflection demonstrates there was no evidence of impact injury.
Parasagittal subdural blood appeared through the incision in the sagittal sinus. Other findings include callus formation was found associated with healing rib fractures on the lateral aspect of the right side of the thorax. Images of the eyes removed en bloc showed obvious optic nerve sheath hemorrhage.
Accessible Version
In this fatal AHT case, the autopsy show very little or no evidence of bleeding outside of the skull or in the scalp. It is only after the scalp is reflected that one sees blood appearing through the fontanel and sagittal sinus in the second image. Once the skull is removed, the subdural hemorrhage is seen in the third image. This child had their eyes removed en bloc, which means that they are cut from the optic nerve and the entire eyeball is fixed before sectioning. This case also had retinal and optic sheath hemorrhages and skeletal survey showed healing rib fractures from prior trauma. These images were obtained with permission from Carl Schmidt, MD.
