{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T03:19:27Z","timestamp":1778642367139,"version":"3.51.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Nonaccidental head injuries are significant causes of morbidity and mortality among young children. Despite broad agreement among medical experts, controversies remain over diagnostic criteria, including from autopsies, because of opinions expressed by a small group of expert witnesses who testify for defendants in suspected child homicide cases. We reviewed 249 autopsies in children 2\u2009years old and younger from the files of our Medical Examiner office in the University of Missouri School of Medicine done between January 1, 2008 and December, 31, 2016. Because of gradually instituted mandatory examination of spinal cords and retinas, we had 127 autopsies with brain examinations by a neuropathologist plus retinal examinations of which 67 also had spinal cord examinations. Results were correlated with clinical records, police and EMS reports, and imaging. We found that subdural hematomas, cerebral edema, and retinal hemorrhages were mostly limited to autopsy findings in children who suffered from fatal head trauma, whether accidental (3 cases) or inflicted (14); they were not encountered in cases of homicide by other mechanisms or from natural diseases including infections, brain tumors, SIDS\/SUID, or SUDC. Two cases with no other evidence of head trauma had focal retinal hemorrhages. We advocate for examination of retinas and spinal cords in all autopsies of children in this age group.<\/jats:p>","DOI":"10.1093\/jnen\/nlac083","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T15:59:18Z","timestamp":1662998358000},"page":"854-864","source":"Crossref","is-referenced-by-count":4,"title":["Neuropathology and Ophthalmological Pathology of Fatal Central Nervous System Injuries in Young Children: Forensic Neuropathology of Deaths of Children Under Age 2, 2008\u20132016, in Central Missouri"],"prefix":"10.1093","volume":"81","author":[{"given":"Douglas C","family":"Miller","sequence":"first","affiliation":[{"name":"From the Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine , Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C Christopher","family":"Stacy","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine , Columbia, Missouri, USA"},{"name":"Office of the Chief Medical Examiner of Boone and Callaway Counties , Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deiter J","family":"Duff","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine , Columbia, Missouri, USA"},{"name":"Office of the Chief Medical Examiner of Boone and Callaway Counties , Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunhua","family":"Guo","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine , Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Morse","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine , Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,12]]},"reference":[{"key":"2024032523481297600_nlac083-B1","volume-title":"Children Maltreatment 2019","author":"Fatalities","edition":"30th ed"},{"key":"2024032523481297600_nlac083-B2","volume-title":"Pediatric Abusive Head Trauma: Recommended Definitions for Public Health Surveillance and Research","author":"Parks","year":"2012"},{"key":"2024032523481297600_nlac083-B3","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/00313029700169724","article-title":"The pathology of fatal child abuse","volume":"29","author":"Ellis","year":"1997","journal-title":"Pathology"},{"key":"2024032523481297600_nlac083-B4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/002580249203200310","article-title":"A study of child homicide over two decades","volume":"32","author":"Hargrave","year":"1992","journal-title":"Med Sci Law"},{"key":"2024032523481297600_nlac083-B5","doi-asserted-by":"crossref","DOI":"10.1201\/9781003158035","volume-title":"Forensic Neuropathology","author":"Whitwell","year":"2021","edition":"2nd ed"},{"key":"2024032523481297600_nlac083-B6","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1007\/s00247-018-4149-1","article-title":"Consensus statement on abusive head trauma in infants and young children","volume":"48","author":"Choudhary","year":"2018","journal-title":"Pediatr Radiol"},{"key":"2024032523481297600_nlac083-B7","doi-asserted-by":"crossref","first-page":"82","DOI":"10.23907\/2011.009","article-title":"Shaken infants die of neck trauma, not of brain trauma","volume":"1","author":"Matshes","year":"2011","journal-title":"Acad Forensic Pathol"},{"key":"2024032523481297600_nlac083-B8","doi-asserted-by":"crossref","first-page":"206","DOI":"10.23907\/2014.032","article-title":"National Association of Medical Examiners position paper: Recommendations for the postmortem assessment of suspected of head trauma in infants and young children","volume":"4","author":"Gill","year":"2014","journal-title":"Acad Forensic Pathol"},{"key":"2024032523481297600_nlac083-B9","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1542\/peds.99.3.371","article-title":"Coagulopathy in pediatric abusive head trauma","volume":"99","author":"Hymel","year":"1997","journal-title":"Pediatrics"},{"key":"2024032523481297600_nlac083-B10","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1089\/neu.2012.2348","article-title":"Traumatic brain injury-associated coagulopathy","volume":"29","author":"Zhang","year":"2012","journal-title":"J Neurotrauma"},{"key":"2024032523481297600_nlac083-B11","author":"Gupta"},{"key":"2024032523481297600_nlac083-B12","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1093\/jnen\/nlw075","article-title":"Hippocampal formation maldevelopment and 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