Conclusion

In pediatric non accidental injury cases, postmortem evaluation is often challenging, particularly in infants in whom external signs of trauma may be limited. This study documents the distribution of intracranial, ocular, spinal, and extracranial findings observed in infants with homicidal blunt head trauma and highlights the frequent involvement of the cervical spinal cord and associated meningeal structures.

The observed cervical spinal findings underscore the importance of careful examination of the cervicomedullary region during forensic autopsy. Although these findings are not diagnostic in isolation, their documentation may contribute to a more complete anatomical assessment when interpreted in conjunction with intracranial and extracranial injuries.

The en bloc cervical spine dissection technique described is presented as a technical option to enhance visualization and preservation of cervical structures in selected cases. Its use requires appropriate expertise and resources and should be guided by case specific considerations rather than applied routinely.

It is critical to recognize that autopsy findings alone can only support a thorough medicolegal death investigation and should not be used in isolation to diagnose inflicted head trauma in children. Comprehensive and well documented postmortem examinations, including appropriate ancillary studies, are essential to address alternative explanations and to clearly define anatomical findings in complex pediatric deaths, supporting scientific transparency and clarity in medicolegal proceedings.