There has been no previous report focusing on bruising in abusive fractures.
Subarachnoid Hemorrhage Due to trauma usually thin and on convexities.
Both bruises and fractures may be seen in the same patient.
When faced with a child who has sustained a fracture, investigators, the courts, and clinicians sometimes are puzzled as to the absence of bruising over the area of fracture.
Micro: histologically apparent after 12-24 hrs survival by silver stains or H&E; At 3-4 hrs if use -APP (as early as 1.5 hrs). ] axonal spheroid s("retraction balls") in corpus callosum, long white matter tracts and brainstem.
Peak at 2 -3 wks after injury, then replaced by gliosis.
According to these arguments, such patients would demonstrate increased vulnerability of the bone due to metabolic disease and thus require less force to produce bony injury, leaving no cutaneous finding.