The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.
Review last updated in March 2010
Abusive head trauma (AHT) is the term the American Academy of Pediatrics 1 recommends that paediatricians use when describing an inflicted injury to the head and its contents. AHT remains the commonest form of fatal child abuse and predominantly affects infants.2 The challenge for the clinician is distinguishing AHT from non-abusive head trauma and determining which children with suspected AHT should undergo neuroimaging.
It is well recognised that a number of children with AHT may have this diagnosis missed when they first come into contact with child health practitioners.3
Current controversies exist around clinicians’ ability to confidently diagnose AHT; we hope this review highlights the strength of evidence that one can rely on in this regard.
The review seeks to answer the following review questions:
- What neuroradiological investigations are indicated to identify abusive central neurological system injury in children?
- What are the distinguishing clinical features of abusive head trauma in children?
- What neuroradiological features distinguish abusive from non-abusive head trauma?
References
- Christian CW, Block R, Committee on Child Abuse and Neglect, American Academy of Pediatrics. Policy statement: abusive head trauma in infants and children. 2009;123(5):1409-1411 [Pubmed]
- Keenan HT, Runyan DK, Marshall SW, Nocera MA, Merten DF. A population-based comparison of clinical and outcome characteristics of young children with serious inflicted and noninflicted traumatic brain injury. Pediatrics. 2004;114(3):633-639 [Pubmed]
- Jenny C, Hymel KP, Ritzen A, Reinert SE, Hay TC. Analysis of missed cases of abusive head trauma. Journal of American Medical Association. 1999;281(7):621-626 [Pubmed]