Original ArticlesHistory of an Abusive Head Trauma Including a Lucid Interval and a Retinal Hemorrhage Is Most Likely FalseDe Leeuw, Marc MD*†; Beuls, Emile Aloïs MD*; Jorens, Philippe G. MD, PhD‡; Parizel, Paul M. MD, PhD§; Jacobs, Werner MD, PhD*Author Information From the *Department of Forensic Medicine and Pathology, University Hospital Antwerp, University of Antwerp, Edegem; †Department of Emergency Medicine, Stedelijk Ziekenhuis Aalst, Aalst; and Departments of ‡Critical Care Medicine and §Radiology, University Hospital Antwerp, University of Antwerp, Edegem, Belgium. Manuscript received January 13, 2013; accepted June 12, 2013. The authors report no conflicts of interest. Reprints: Werner Jacobs, MD, PhD, Department of Forensic Medicine Antwerp University Hospital, University of Antwerp Wilrijkstraat 10, B-2650 Edegem, Belgium. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: September 2013 - Volume 34 - Issue 3 - p 271-276 doi: 10.1097/PAF.0b013e3182a0a454 Buy Metrics Abstract A lucid interval (LI) is the period of time between regaining consciousness after a short period of unconsciousness, resulting from a head injury and deteriorating after the onset of neurologic signs and symptoms caused by that injury. The incentive for this study was the case of a father who left his 14-week-old infant with the nanny in whose custody the infant had collapsed. The nanny denied involvement in the injury, and the father became a suspect. Of 47 abusive head trauma (AHT) cases, 8 were found to have an LI in the past. The history of the cases were thoroughly analyzed and compared with evidence in the literature. An LI is not compatible with an inertial brain injury. Shaking has either an immediate effect or no effect, which means that an LI occurs only in pure impact or blunt injuries. When “shaking lesions” are found including a retinal hemorrhage while the history mentions an LI, the story most likely is false, regardless of whether the perpetrator confesses. The finding of an LI may change the assessment of an AHT case. Lucid interval is a valuable variable in the diagnostic accuracy of an AHT. © 2013 by Lippincott Williams & Wilkins.