Forensic Medical Question: Forensic MRI for Child Abuse

Susan Asks:

mri-782459_1920Is there such a thing as a forensic MRI? Not to be done on a dead person, but in a child abuse case? Can one tell if a child has been beaten and see healed bruises, etc?

Jordyn Says:

Thanks for your questions.

The only indication I can think of using MRI to discern abuse would be for head trauma. MRI is the most sensitive study when it comes to differentiating old and new bleeds (as in possibly discerning two episodes of shaking), but still an exact time of the bleed could probably not be given. We just would know there were two separate instances of injury that caused bleeding.

Also, it wouldn’t be called a forensic MRI on a live child. We would just call it by the study we’re doing. In this case, a brain MRI, but the reason for doing the study would be concern for child abuse and/or intracranial (inside the brain) bleeding.

You can’t really tell healed bruises because they’re healed after all. The skin would have normal appearance. We could at least take a history of where the bruises were because we know normal versus abnormal bruising patterns in children, but pictures are always more impressive so seeing current injuries will always be better if trying to build a child abuse case.

Perhaps you’re thinking about healed fractures which you could possibly see some evidence of healed fractured on x-rays depending on how significant the fracture was. However, not all healed fractures are visible on x-ray. Healing fractures can be seen on x-ray.

Historical Medical Question: Head Injury 1870s

April Asks:

skull-476740_1920I have a question regarding medicine in the 1870’s.  What would brain/cranial surgery consist of then?

I’ve tried to find some information on this type of operation from this time period, but have had very little luck so far.  In a quick scenario, there’s been a serious buggy accident, and the heroine of the novel has bleeding on the brain. I know one proposed procedure for this was to actually drill a hole into the skull to let out the influx of blood. Was this happening and being practiced in the 1870’s? Also, what would the medical instruments of the day have been to achieve such a surgery?

Jordyn Says:

This could definitely be a set up for a craniotomy (drilling a hole into the skull or creating a burr hole) to be used to relieve pressure within the cranium. The procedure would have been called trephining and was definitely used during your time period. Two resources for the procedure can be found here and here.