(Received 29 September 1999; accepted 27 October 1999)
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We report a case of a two-month-old boy who became unresponsive in the sole custody of his father. Resuscitation efforts on route to the hospital were able to restore the infant's heart beat. However, neurologic function never recovered. Autopsy revealed massive cerebral edema, recent subdural, and subarachnoid hemorrhages, bilateral retinal hemorrhages, and cervical spine ligament hemorrhages. Separation of individual cervical vertebrae showed extensive, bilateral, periadventitial vertebral artery hemorrhages between C1 and C4, with corresponding luminal compression of the vertebral arteries. The importence of this previously unreported phenomena of periadventitial vertebral artery hemorrhage in the setting of shaken baby syndrome is discussed.
College of Physicians and Surgeons of Columbia University, New York, NY
The Office of the Chief Medical Examiner, Commonwealth of Massachusetts, Boston, MA
University of Massachusetts-Memorial Medical Center, Worcester, MA
Stock #: JFS14844J