William A. Cox, M.D., FCAP Forensic Pathologist/Neuropathologist
October 18, 2017
At this point in my career I have practiced Forensic Pathology for 43 years and Neuropathology for 41 years. Some of the most contentious cases I have had to deal with are those involving the death of a child in which non-accidental injury, child abuse, is believed to be the under lying causation of death. The determination of the cause of death in a child requires the forensic pathologist performing the postmortem examination to have a thorough understanding of the investigatorial information surrounding the circumstances, which led to the child’s death, as well as their past and present medical records. It is also essential the forensic pathologist approaches the clinical history, medical records and the findings of a very thorough autopsy in an unbiased and objective manner, free from all prejudice, and exercising eminent fairness in evaluating all facts of the case. It is equally important the forensic pathologist consider all literature related to the issues deemed responsible for the child’s death and not just the child abuse literature. It is important in the evaluation of alleged cases of child abuse that there be consideration of the non-CAC (child abuse community) peer- reviewed literature that challenges, if not refutes many of the unproven CAC teachings. Consensus statements from the American Academy of Pediatrics and the Society for Pediatric Radiology in-of-themselves do not create or validate science. Continue reading Child Abuse and the Lack of Intellectual Integrity
This article is a brief summary of the 19 page article entitled “Traumatic Spinal Cord Injuries,” published as a Forensic Science Newsletter on January 15, 2017.
The earliest known reference to traumatic lesions of the spinal cord are found in the Edwin Smith Surgical Papyrus. During World War I, Riddoch, and later Head and Riddoch, gave what are now considered the classic descriptions of spinal transection in humans. World War II marked the turning point in the understanding and management of spinal injuries. Continue reading Injuries to the Vertebral Column and Spinal Cord: A Summary
Forensic Science Newsletter: January 2017
In this Forensic Science Newsletter we will discuss traumatic spinal cord injuries.
Traumatic lesions of the spinal cord usually result from injuries which cause vertebral fractures. The spinal cord may, however, be injured by vertebral dislocation without fracture or by penetrating wounds of the canal.
The common sites of injury are at levels of the upper cervical, the mid cervical, the lower cervical, the lower thoracic, and the upper lumbar vertebrae. In approximately three-fourths of the cases of fracture of the cervical vertebrae, the spinal cord is injured. Slightly more than half of the fractures of the thoracic spine and only about one-fourth of the fractures of the lumbar spine were associated with spinal cord injury.
Continue reading Traumatic Spinal Cord Injuries
In the highly regarded Neurology Textbook, “Principles of Neurology,” by Adams and Victor, tenth edition, it is stated post-concussion syndrome is virtually unknown in children. However, a careful search of the scientific neuropathology literature suggest otherwise.
In our latest Newsletter, “Post-Concussion Syndrome-Children” an in depth discussion of this issue is presented. You can also sign up here to receive our Forensic ScienceNewsletter by email.
Definition of Post-concussion syndrome (PCS)
A name given to symptoms that develop following a concussion, which persist for an extended time. Most concussions in children resolve in 7-10 days.
Most children and adolescent athletes return to their normal activities within two weeks. Those who develop post-concussion syndrome have symptoms, such as tiredness, headache, memory loss, dizziness, irritability, poor attention, depression, difficulty in concentration, sleep problems, and personality changes that last for at least one month. Continue reading Does Post-Concussion Syndrome Commonly Occur in Children
Although there is much confusion in the literature regarding what is post-concussion syndrome, a picture is beginning to emerge, which provides clarity as to our understanding of its seemingly confusing presentation.
In our latest Newsletter, “Post-Concussion Syndrome-Adults,” we present a comprehensive analysis of this subject. The following blog article is meant only to touch on some of the aspects of this complex subject. You can also sign up here to receive our Forensic Science Newsletter by email.