title: Fatal acute intracranial injury, subdural hematoma, and retinal hemorrhages caused by stairway fall.
abstract: We describe an infant with an acute subdural hematoma, a fatal head injury, and severe hemorrhagic retinopathy caused by a stairway fall. His cerebral and ocular findings are considered diagnostic of abusive head trauma by many authors. Our literature search of serious injuries or fatalities from stairway or low-height falls involving young children yielded 19 articles of primary data. These articles are discrepant, making the classification of a young child's death following a reported short fall problematic. This case report contradicts the prevalent belief of many physicians dealing with suspected child abuse that low-height falls by young children are without exception benign occurrences and cannot cause fatal intracranial injuries and severe retinal hemorrhages. The irreparable harm to a caregiver facing an erroneous allegation of child abuse requires physicians to thoroughly investigate and correctly classify pediatric accidental head injuries.
authors.affiliation: Department of Pathology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1072, USA. plantz@wfubmc.edu
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Lantz
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Couture
mesh_terms: D000058:Accidental Falls; D001930:Brain Injuries / Q000473:pathology*; D017809:Fatal Outcome; D049429:Forensic Pathology; D020199:Hematoma, Subdural, Acute / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D009887:Ophthalmoscopy; D012166:Retinal Hemorrhage / Q000473:pathology*; D014057:Tomography, X-Ray Computed