Persistent Retinal Iron in Abusive Head Trauma

Babette Bais, Wouter A. Karst, Bela Kubat, Robert M. Verdijk*

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review


Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5-month-old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas, and retinal hemorrhages consistent with abusive head trauma (AHT). At the age of 3, he was readmitted to hospital with spontaneous osteopenic fracture of the right femur. The patient deteriorated and died after unsuccessful resuscitation. Ophthalmopathological investigation showed atrophy of the retina and optic nerve and hemosiderin deposition in both eyes. Retinal hemosiderin deposition is currently generally assumed to disappear within 6-8 weeks after the occurrence of hemorrhage in AHT. This case report describes an infant with bilateral retinal hemosiderin depositions due to hemorrhages sustained from AHT occurring 32 months prior to death. Implications of this finding for the interpretation of retinal hemosiderin depositions in AHT are discussed.? 2016 American Academy of Forensic Sciences.
Original languageEnglish
Pages (from-to)1693-1696
JournalJournal of Forensic Sciences
Issue number6
Publication statusPublished - Nov 2016


  • forensic science
  • abusive head trauma
  • shaken baby syndrome
  • child abuse
  • retinal hemorrhages
  • hemosiderin
  • pathology
  • long-term survivor
  • ophthalmic pathology


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