Evaluating for Suspected Child Abuse: Conditions That Predispose to Bleeding

Carpenter, Shannon L.; Abshire, Thomas C.; Anderst, James D.; Hord, Jeffrey D.; Crouch, Gary; Hale, Gregory A.; Mueller, Brigitta U.; Rogers, Zora R.; Shearer, Patricia; Werner, Eric; Feig, Stephen A.; Kodish, Eric; Gamis, Alan S.

doi:10.1542/peds.2013-0196

Cited by 55 publications

(16 citation statements)

References 129 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is important for the clinician to remember that most bleeding disorders are rare; the more common bleeding disorders typically are mild; and intracranial hemorrhage resulting from bleeding disorders is a rare complication of the more severe diseases. 52 Furthermore, intracranial hemorrhage, as the initial presentation of an underlying coagulopathy, is an extremely rare event.…”

Section: Bleeding Disordersmentioning

confidence: 99%

Abusive Head Trauma

Narang

Clarke

2014

J Child Neurol

View full text Add to dashboard Cite

Abusive head trauma has a robust and interesting scientific history. Recently, the American Academy of Pediatrics has endorsed a change in terminology to a term that is more general in describing the vast array of abusive mechanisms that can result in pediatric head injury. Simply defined, abusive head trauma is "child physical abuse that results in injury to the head or brain." Abusive head trauma is a relatively common cause of childhood neurotrauma, with an estimated incidence of 16 to 33 cases per 100,000 children per year in the first 2 years of life. Clinical findings are variable; AHT should be considered in all children with neurologic signs and symptoms, especially if no or only mild trauma is described. Subdural and retinal hemorrhages are the most common findings. The current best evidence-based literature has identified some features--apnea and severe retinal hemorrhages--that reliably discriminate abusive from accidental injury. Longitudinal studies of outcomes in abusive head trauma patients demonstrate that approximately one-third of the children are severely disabled, one third of them are moderately disabled, and one third have no or only mild symptoms. Abusive head trauma cases are complex cases that require a rigorous, multidisciplinary team approach. The clinician can establish this diagnosis with confidence if he/she maintains a high index of suspicion for the diagnosis, has knowledge of the signs, symptoms, and risk factors of abusive head trauma, and reasonably excludes other etiologies on the differential diagnosis.

show abstract

Section: Bleeding Disordersmentioning

confidence: 99%

Abusive Head Trauma

Narang

Clarke

2014

J Child Neurol

View full text Add to dashboard Cite

show abstract

“…Accidental head trauma (epidural, subdural, subarachnoid, cerebellar and parenchymal hemorrhage), bleeding diathesis [ 60 ], arteriovenous malformation [ 61 ], stroke, neoplastic conditions [ 62 ], metabolic disorders [ 63 ], connective tissue diseases, osteogenesis imperfecta [ 64 ], glutaric aciduria [ 65 ], and vitamin K deficiency [ 66 ] are all the differential diagnosis. These conditions have similar findings as AHT and must be excluded [ [67] , [68] , [69] ].…”

Section: Differential Diagnosismentioning

confidence: 99%

Pediatric abusive head trauma

Hung

2020

Biomedical Journal

View full text Add to dashboard Cite

Abusive head trauma (AHT), used to be named shaken baby syndrome, is an injury to the skull and intracranial components of a baby or child younger than 5 years due to violent shaking and/or abrupt impact. It is a worldwide leading cause of fatal head injuries in children under 2 years. The mechanism of AHT includes shaking as well as impact, crushing or their various combinations through acceleration, deceleration and rotational force. The diagnosis of AHT should be based on the existence of multiple components including subdural hematoma, intracranial pathology, retinal hemorrhages as well as rib and other fractures consistent with the mechanism of trauma. The differential diagnosis must exclude those medical or surgical diseases that can mimic AHT such as traumatic brain injury, cerebral sinovenous thrombosis, and hypoxic-ischemic injury. As for the treatment, most of the care of AHT is supportive. Vital signs should be maintained. Intracranial pressure, if necessary, should be monitored and controlled to ensure adequate cerebral perfusion pressure. There are potential morbidity and mortality associated with AHT, ranging from mild learning disabilities to severe handicaps and death. The prognosis of patients with AHT correlates with the extent of injury identified on CT and MRI imaging. The outcome is associated with the clinical staging, the extent of increased intracranial pressure and the existence of neurological complications such as acquired hydrocephalus or microcephalus, cortical blindness, convulsive disorder, and developmental delay. AHT is a potentially preventable disease, therefore, prevention should be stressed in all encounters within the family, the society and all the healthcare providers.

show abstract

“…Lesions with defined patterns are a strong indicator of abuse, as are multiple injuries, clustered, with unusual locations, distant from bony prominences and in different stages of healing [8,15]. There are, however, conditions that predispose to bleeding, such as disease Von Willbrand among other forms of anaemia and should be considered in the differential diagnosis of lesions [18,19].…”

Section: Introductionmentioning

confidence: 99%

Injuries of Non-Lethal Child Physical Abuse to the Crania and Orofacial Regions: A Scientific Review

Banheiro¹,

C²,

C³

2015

J Forensic

View full text Add to dashboard Cite

The literature states that maltreatment in childhood and youth make up a problem on a global scale that exceeds ethnicities, religions, cultures, social and economic classes. It is also said that more than half of the injuries from maltreatment occur in the head and face. Assuming the particular relevance of orofacial structures, the dentist must know how to observe and recognize the indicators and properly diagnose the injury by maltreatment. This scientific review aimed to understand what types of intraoral lesions, signs or external lesions of the head or neck can be associated with child maltreatment. One primary database was searched so that systematic review articles and meta-analysis, case reports or case series of intraoral lesions, signs or external lesions of the head or neck by child maltreatment could be acquired. The references in the works acquired by electronic search were manually researched and the authors of all possibly relevant papers were contacted. In all searches inclusion and exclusion criteria were applied. Of the twenty two papers included two were systematic reviews and twenty were case reports or case series. The twenty articles of case reports or case series exposed information from thirty-five clinical cases included. Despite the limitations of scientific evidence it can be concluded that oral cavity, head and neck regions are home to multiple and diverse injuries by maltreatment of children and youngsters.

show abstract

Evaluating for Suspected Child Abuse: Conditions That Predispose to Bleeding

Cited by 55 publications

References 129 publications

Abusive Head Trauma

Abusive Head Trauma

Pediatric abusive head trauma

Injuries of Non-Lethal Child Physical Abuse to the Crania and Orofacial Regions: A Scientific Review

Contact Info

Product

Resources

About