Abusive head trauma: recognition and the essential investigation

Abstract

Abusive head trauma (AHT) affects one in 4000-5000 infants every year and is one of the most serious forms of physical child abuse that has a high associated mortality and morbidity. Differentiating this form of abuse from another potential cause of brain injury is of utmost importance to the welfare of the child concerned and it is essential that the condition is correctly diagnosed. This article describes the evidence base behind the associated historical, clinical and neuroradiological features of AHT and spinal injury in physical abuse and sets out an algorithm of essential investigations that should be performed in any infant or young child where AHT is suspected.

Neuroimaging differential diagnoses to abusive head trauma

“…The parietal bone is the most frequent site of fracture in abused children as well as in those with accidental injury. The most common profile of fracture types seen in both causes is a linear fracture [12]. As noted by Meservy et al [13], radiologic features significant for abusive head trauma consist of multiple fractures, bilateral fractures and fractures that cross suture lines (Fig.…”

“…From a clinical point of view, the mean age of children with accidental trauma is higher than the mean age of children with abusive trauma [11,12]. Accidental trauma is always a witnessed trauma.…”

Osteogênese Imperfeita: Relato De Caso

“…A história clínica e a avaliação da criança e sua família tornaram-se fundamentais para identificação da OI e afastamento da hipótese de maus tratos. [22][23][24] É importante investigar causas secundárias de osteoporose, como malignidade, doenças inflamatórias e endocrinológicas de acordo com o contexto clínico. 25 As sequelas pós traumáticas em crianças pequenas nos lobos temporal e frontal são compatíveis com déficit de memória, nas funções executivas, desempenho escolar e habilidades de linguagem como encontrados no paciente, assim como a no córtex occipital relacionada à redução da acuidade visual.…”

Factors associated with multi-disciplinary case conference outcomes in children admitted to a regional hospital in Hong Kong with suspected child abuse: a retrospective case series with internal comparison

“…16,17,19,22 Social isolation was more common among single parents or immigrants. 15 Both a low level of real and perceived social support has been shown to be potential risks for child maltreatment.…”