Update on abusive head trauma

  title={Update on abusive head trauma},
  author={Ashkon Shaahinfar and K D Whitelaw and Karim M. Mansour},
  journal={Current Opinion in Pediatrics},
Purposes of review This article provides an update on abusive head trauma (AHT), focusing on new developments most salient to the emergency medicine clinician, including epidemiology, clinical recognition, diagnostic work-up, management of neurologic injury, and public health implications. Recent findings The recent literature has focused on honing the clinician's ability to recognize AHT and its immediate sequelae, to more accurately distinguish between abusive and accidental head injuries by… Expand
Abusive Head Trauma
A multidisciplinary team approach to the management of the child suffering AHT is paramount and the family will need psychosocial support. Expand
Child maltreatment: a review of key literature in 2015
  • A. Newton
  • Medicine
  • Current opinion in pediatrics
  • 2016
Purpose of review This review addresses some of the more salient articles in the field of child maltreatment published in 2015, with a goal of helping the general practitioner understand theExpand
A retrospective review of paediatric head injuries in Asia – a Pan Asian Trauma Outcomes Study (PATOS) collaboration
Among children with head injuries, traffic injuries are independently associated with death, endotracheal intubation and neurosurgery, and this collaboration among Asian centres holds potential for future prospective childhood injury surveillance. Expand
Cerebrospinal Fluid Interaction with Cerebral Cortex during Pediatric Abusive Head Trauma
This model is one of the first fluid–structure interaction frameworks that uses fluid material properties to represent the cerebrospinal fluid (CSF) while including all major anatomical features of the brain. Expand
Long-term impact of abusive head trauma in young children: Outcomes at 5 and 11 years old.
AHT is associated with significant long-term disability by age 5 and the incidence increased by age 11 years and there is an association between age at time of AHT and long- term outcomes. Expand
Traumatic brain injury biomarkers in pediatric patients: a systematic review
S100B measurement has high sensitivity and great promise in diagnosing pediatric TBI, ideally when associated with head CT examination and clinical decision protocols, and further large-scale longitudinal studies addressing TBI biomarkers in children are required. Expand
Physical Child Abuse
The nature of injuries that may be a found in abused children and a framework for their assessment are described and abusive head trauma and fabricated or factitious illnesses are discussed. Expand
Pediatric Neuro-Ophthalmology and OCT
The field of pediatric neuro-ophthalmology has burgeoned over the past decade due to the more available diagnostic and therapeutic tools and this multidisciplinary field requires the collaborative work of a geneticist, pediatric ophthalmologist, children's ophthalmic-oncologists with coordination of a pediatric neuro -ophthalmologist. Expand
Schütteltrauma vs. Impfkomplikation
An encephalopathy with subdural and retinal haemorrhage is considered to be the typical diagnostic triad of shaken baby syndrome, and the evidentiary value of these findings and their pathophysiology are frequent topics of controversy between experts. Expand


Abusive Head Trauma in Infants and Children
The American Academy of Pediatrics recommends that pediatricians develop skills in the recognition of signs and symptoms of abusive head injury, including those caused by both shaking and blunt impact, consult with pediatric subspecialists when necessary, and embrace a less mechanistic term, abusive head trauma, when describing an inflicted injury to the head and its contents. Expand
Validation of a Clinical Prediction Rule for Pediatric Abusive Head Trauma
Four readily available variables identify AHT with high sensitivity in young, acutely head-injured children admitted to the PICU in a new, equivalent patient population. Expand
The eye in child abuse: Key points on retinal hemorrhages and abusive head trauma
This review presents an up-to-date overview of ocular injuries resulting from child abuse, with a spotlight on abusive head trauma, and key distinctions among retinal hemorrhage patterns, severity and frequencies are highlighted. Expand
Analysis of missed cases of abusive head trauma.
Although diagnosing head trauma can be difficult in the absence of a history, it is important to consider inflicted head trauma in infants and young children presenting with nonspecific clinical signs. Expand
ACR Appropriateness Criteria head trauma--child.
MRI may be helpful in patients with suspected nonaccidental trauma, with which axonal shear injury and ischemia are more common and documentation is critical, as well as in those whose clinical status is discordant with CT findings, but data are currently insufficient to support routine clinical use. Expand
Derivation of a Clinical Prediction Rule for Pediatric Abusive Head Trauma*
  • K. Hymel, D. Willson, +8 authors S. Narang
  • Medicine
  • Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2013
If validated, a reliable, sensitive, abusive head trauma clinical prediction rule could be used by pediatric intensivists to calculate an evidence-based, patient-specific estimate of abuse probability that can inform—not dictate—their early decisions to launch (or forego) an evaluation for abuse. Expand
Abusive Head Trauma in Young Children: A Population-Based Study
Intracranial bleeding is a cardinal feature of AHT to be considered in case ascertainment to improve public health surveillance and identify risk characteristics for recognizing high-risk children to improvePublic health surveillance. Expand
Abusive head trauma: differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys.
There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between hit and miss injuries was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures. Expand
Retinal haemorrhage in abusive head trauma
Although there is a wide differential diagnosis for retinal haemorrhages, clinical appearance, when considered in the context of systemic and laboratory findings, usually leads to the correct diagnosis. Expand
Factors associated with hemispheric hypodensity after subdural hematoma following abusive head trauma in children.
A variety of insults associated with ischemia, including intracranial hypertension, ICP-directed therapies, hypoxia, hypotension, and cardiac arrest, occurred in the children who developed HH. Expand