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December 1992

Fatalities Associated With Misinterpretation of Bloody Cerebrospinal Fluid in the 'Shaken Baby Syndrome'

Author Affiliations

Anesthesia/Critical Care; Child Protection Services; Anesthesia/Critical Care Children's Hospital and Health Center 1130 Flora Ave Coronado, CA 92118

Am J Dis Child. 1992;146(12):1415-1417. doi:10.1001/archpedi.1992.02160240025007

Sir.—Despite increased awareness of the presence of child abuse, nearly 1100 children still succumb to fatal shaking or blunt traumatic injuries inflicted by adults each year in the United States.2 Nearly 150000 children suffer serious injuries and many are permanently disabled.2 Therefore, it is extremely important that clinicians recognize any sign, symptom, or laboratory result in a child that may be a manifestation of child abuse if further abuse and perhaps death are to be prevented.

A previous report3 described three patients in whom the diagnosis of child abuse was delayed because of misinterpretation of bloody cerebrospinal fluid (CSF). We report herein two fatal cases involving children who underwent diagnostic lumbar puncture that yielded bloody CSF that

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