Sudden and unexpected death in infancy and childhood: neuropathological findings.

This report describes the neuropathological findings in 58 infants and children dying suddenly and unexpectedly. Utilizing historical, clinical, laboratory and pathological findings, two subgroups were distinguished: in one a cause of death was established (CODE); members of the other (more than 50% of the total sample) were victims of sudden infant death syndrome (SIDS). The importance of historical as well as pathological data in excluding SIDS is stressed. In each subgroup, both focal lesions and diffuse glial reactive hypertrophy were identified in 64% of all children below 9 months of age. These changes were not related to age group or maturation and, except for a history of perinatal asphyxia, lesions were not predictably correlated with clinical data. The brains of children dying of established cause (CODE) are not a suitable control group with which to compare those of SIDS.