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. 2021 Feb 22;135(4):1481–1498. doi: 10.1007/s00414-021-02526-x

Table 4.

Spinal cord AHT pathological findings: evidence from neuropathology (case series and case reports). Is intracranial SDH associated?

Study Cases Spinal cord injuries Intracranial SDH in AHT cases Is intracranial SDH inclusion criteria?
Serinelli et al., 2017 [58]

51 homicide victims

(42 AHT)

(<3 yo)

Spinal cord injuries at toracholumbar (33%) > lumbosacral 27.5 > cervical 15.5% Yes (82.4%) No
Brennan et al., 2009 [36]

41 AHT and 11 accidental head trauma

(<2 yo)

71% AHT had primary cervical spinal cord injuries: 72% parenchymal, 83% meningeal haemorrhages, 55% nerve roots (avulsion, haemorrhages). Yes (92%) No
Geddes et al., 2001 (II) [59]

37 AHT (<9 mo, ma 2.4 mo)

14 non-traumatic (<11 mo, ma 3 mo)

3/28 AHT showed βAPP positivity in cervical cord and/or dorsal nerve roots

8/28 AHT showed βAPP positivity in the lower pons and medulla

0/14 non-traumatic had βAPP positivity.

Yes (81%) No
Geddes et al., 2001 (I) [32] 53 AHT (0.5–97 mo, ma 4 mo)

3/53 had EDH

3/53 AHT showed βAPP positivity in cervical cord

8 AHT showed βAPP positivity in the lower pons and medulla.

Yes (81%) No
Saternus et al., 2000 [31]

4 AHT (shaking only)

(3 autopsied and 1 survived)

(4–30 mo, ma 13.7 mo)

1/3 had cervical EDH (dorsal, C2/C3–C5/T2)

Survived children had blood-stained CSF.

Yes (50%) No
Shannon et al., 1998 [60]

13 AHT (shaken only) (<2 yo, ma 5 mo)

7 hypoxia, 6 sudden asphyxia- children.

7/11 AHT showed βAPP positivity in cervical cord and in spinal nerve roots, as opposed to none of the control groups. Yes No
Feldman et al., 1997 [40]

5 AHT

(1.3–34.1 mo, ma 5.8 mo)

1/5 had SDH at the upper cervical cord, in continuity with cranial SDH

3/5 had SAH at the cervical cord level, in association with similar intracranial findings

Yes Yes
Hadley et al., 1989 [28]

13 AHT (shaken only)

(ma 3 mo)

(6 autopsied)

5/6 had EDH at cervicomedullary junction

4/6 had SDH at cervicomedullary junction

4/6 had ventral spinal contusions at high cervical levels

Yes No

AHT abusive head trauma, βAPP β amyloid precursor protein, EDH epidural haematoma, yo years old, ma mean age, mo months old, MRI magnetic resonance, SAH subarachnoid haematoma, SDH subdural haematoma