Methods

A retrospective review of pediatric cases from the Cook County Medical Examiner’s Office in Chicago, Illinois, United States (CCMEO) was conducted using the office digital database ‘LabLynx’ (LabLynx, Inc., Smyrna, Georgia, U.S). Cases of children under one year of age in whom the manner of death was certified as homicide and in whom blunt force head injuries were found were selected. In each case, autopsy reports, toxicology findings, investigative and police reports, and, when available, reports from the Department of Children and Family Services were systematically reviewed alongside radiological studies, neuropathological examinations, and ophthalmological assessments; toxicology, investigative, police and Department of Children and Family Services reports, when available, were reviewed.

All autopsies were performed by board-certified forensic pathologists at the Cook County Medical Examiner’s Office. Neuropathological and ophthalmological evaluations were conducted by board-certified specialists affiliated with local academic institutions. Brain, spinal cord, and ocular tissue removal and examination followed standard autopsy protocols as outlined in the literature [17–23].

Following case selection, documented injuries were categorized based on external and internal findings. Radiological studies, histological findings, neuropathological and ophthalmological examinations, and toxicological results were reviewed to identify and correlate additional injury patterns and relevant ancillary data.

Data was organized using Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA) with emphasis on the following variables: sample size, age, sex, race, scalp and facial trauma, subgaleal hemorrhage (SGH), skull fractures, extradural, intradural, and subdural hemorrhages (EDH, IDH, and SDH), subarachnoid hemorrhage (SAH), intracerebral and spinal cord pathology, and ocular findings.