RUPTURED VASCULAR MALFORMATION MASQUERADING AS BATTERED SHAKEN BABY SYNDROME - A NEARLY TRAGIC MISTAKE

Battered/shaken baby syndrome is a clinical and pathologic diagnosis b ased on clinical examination, central nervous system dysfunction, and intracranial, optic nerve sheath, and retinal hemorrhages in infants u nder the age of three years. This report describes a case in which the battered/shaken baby syndrome was suspected because of an unusual par ental reaction to an acute, mortal illness in their seven-week-old bab y, as well as an acute intracranial hemorrhage coupled with the discov ery of optic nerve sheath hemorrhages at necropsy. Thorough microscopi c study, however, uncovered an unusual subarachnoid vascular malformat ion, the rupture of which led to the death of the infant. This case un derscores the importance of complete postmortem examinations in cases of suspected child abuse, and teaches caution in jumping to hasty conc lusions.