CASE REPORT   

Minerva Forensic Medicine 2023 December;143(4):150-4

DOI: 10.23736/S2784-8922.23.01857-5

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Multicystic encephalopathy in abusive head trauma: report of three cases

Andreas BÜTTNER ¹, Gabriele NAPOLETANO ² ✉

¹ Institute of Legal Medicine, Rostock, Germany; ² Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University, Rome, Italy

Multicystic encephalopathy (MCE) in abusive head trauma (AHT) (“shaken baby syndrome” [SBS]) is a rare condition, in which only a few cases of delayed homicides have been described. We present three cases of MCE deaths after AHT with different degrees of cystic degeneration (1-5 months, age at time of AHT; post traumatic interval, (PTI): 2 years to 29 years). Reviewing the patient’s clinical history can be useful for the presence of the classic triad (retinal hemorrhages, subdural hemorrhages and encephalopathy) and further traumatic and/or neglected lesions. The topography of the brain regions involved may not only suggest a hypoxic-ischemic and/or hypoperfusion mechanism but could also be helpful for the search of the primary damage at the level of the brainstem regulatory nuclei. Although MCE may be a typical lesion in developing brains after different insults, we did not observe age-related changes in our cases. Research in this area of forensic neuropathology can give an important contribution to the understanding of AHT in infants.

KEY WORDS: Craniocerebral trauma; Neuropathology; Forensic medicine; Brain hypoxia-ischemia; Shaken baby syndrome