SAGE Publications, Pediatric and Developmental Pathology, 3(16), p. 149-159, 2013
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Abstract We analyzed the presence or absence of intradural hemorrhage (IDH) and subdural hemorrhage (SDH) and the degree of histological features of hypoxia (HIE) in the brain of all non-macerated fetuses of > 24 weeks, neonates and children up to 3 years who died of natural causes over a defined period. We looked into the cause or relevant pathology at death, the type of birth (in those under 1 month) and the performance of cardio-pulmonary resuscitation in our cohort. The IDH was classified as macroscopic or negative/microscopic; the HIE was classified as absent, indeterminate or definite. In fetuses, SDH with IDH was present in 22%; IDH alone was present in 31% and there was no or minimal hemorrhage in 47%. In infants and children SDH with IDH was present in 19%; IDH alone was present in 32% and there was no or minimal hemorrhage in 49%. There was a statistically significant correlation between SDH and HIE, especially in infants and children (p < 0.001). When cases were grouped per age, a significant association between age and hemorrhage (p < 0.0001) was demonstrated, SDH being more common in infants {less than or equal to}1 month corrected age. Conclusion: IDH can be the source of thin film SDH in fetuses, infants and young children. The presence of SDH is associated with hypoxia. Intradural and subdural hemorrhages are more common in autopsies of infants under 1 month corrected age. Although rarer they can also be found in children between 1 month and 3 years in absence of trauma.