Was Terson's Tersons?

Terson's syndrome has had multiple definitions. The original definition is unlikely to have included Terson's original case. An updated definition based on mechanism is proposed and related to the original case described by Terson.

Infant acute life-threatening event--dysphagic choking versus nonaccidental injury.

A 4-month-old male infant presented to the emergency room with a history of choking while bottle feeding at home, and was found by emergency medical services (EMS) to be apneic and pulseless. He subsequently developed disseminated intravascular coagulopathy and died. Computed tomography (CT) and magnetic resonance imaging (MRI) showed subdural hemorrhages (SDHs), subarachnoid hemorrhage (SAH), and retinal hemorrhages (RHs), along with findings of hypoxic-ischemic encephalopathy (HIE). The caretaker account appeared to be inconsistent with the clinical and imaging features, and a diagnosis of nonaccidental injury with "shaken baby syndrome" was made. The autopsy revealed diffuse anoxic central nervous system (CNS) changes with marked edema, SAH, and SDH, but no evidence of "CNS trauma." Although NAI could not be ruled out, the autopsy findings provided further evidence that the child's injury could result from a dysphagic choking type of acute life threatening event (ALTE) as consistently described by the caretaker.

A witnessed short fall mimicking presumed shaken baby syndrome (inflicted childhood neurotrauma).

A witnessed fall backwards of an infant from a sitting position resulted in the subdural hematoma and retinal hemorrhages characteristic of presumed shaken baby syndrome. Violent shaking is not necessary to produce these findings.