Abusive head trauma: two cases and mini-review of the current literature

Abstract

Background. Abusive head trauma (AHT) is the leading cause of fatal head injuries and are responsible for more than half of serious or fatal traumatic brain injury cases in children younger than 2 years of age. Long-term outcomes of AHT are death, spastic hemiplegia or quadriplegia, intractable epilepsy, microcephaly with corticosubcortical atrophy, visual impairment, language disorder and cognitive, behavioral and sleep disorders. Cases. Herein we present two cases of AHT (7-month-old boy, 7-month-old girl) according to forensic analysis, and discuss them in light of the current literature and share our experience. Inconsistency between the presenting history and the clinical findings were typical in both cases; follow-up histories and detailed workup revealed the diagnosis of AHT. The first case was deceased; the second case was discharged with neurological deficits. Conclusion. A multidisciplinary approach is critical for the prevention, diagnosis and treatment of AHT.

Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis

“…Interpretation of neuroimaging with skilled neuroradiologists, not non-neuroradiologists, can improve the detection rate of AHT [ 17 ]. If there is an SDH on the neuroimaging of infants, AHT should be suspected [ 18 , 19 ]. SDH, multiple interhemispheric, convexity hemorrhages, and cerebral edema on neuroimaging are strongly associated with AHT, not non-abusive head trauma [ 20 ].…”