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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.


  • Seizures were infrequently recorded and only had a weak association with abusive head trauma (AHT) 1-8
  • In a child less than three years of age with intracranial injury and seizure the meta-analysis 9 shows that the positive predictive value for AHT is 66% (95% confidence interval (CI) 45% – 82%) and odds ratio 2.9 (95%CI 0.7 – 11.7) 1-8

Seizures and intracranial injury are associated with AHT, however the figures do not reach statistical significance (this may be due to the small number of cases recorded)


The character and number of seizures was not recorded in all studies. It may be important to look at this in more detail

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  1. Bechtel K, Stoessel K, Leventhal JM, Ogle E, Teague B, Lavietes S, Banyas B, Allen K, Dziura J, Duncan C. Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics. 2004;114(1):165-168 [Pubmed]
  2. Ewing-Cobbs L, Kramer L, Prasad M, Canales DN, Louis PT, Fletcher JM, Vollero H, Landry SH, Cheung K. Neuroimaging, physical, and developmental findings after inflicted and noninflicted traumatic brain injury in young children. Pediatrics 1998;102(2 Pt 1):300-307 [Pubmed]
  3. Fung EL, Sung RY, Nelson EA, Poon WS. Unexplained subdural hematoma in young children: is it always child abuse? Pediatrics International 2002;44(1):37-42 [Pubmed]
  4. Hettler J, Greenes DS. Can the initial history predict whether a child with a head injury has been abused? Pediatrics 2003;111(3):602-607 [Pubmed]
  5. Hobbs C, Childs AM, Wynne J, Livingston J, Seal A. Subdural haematoma and effusion in infancy: an epidemiological study. Archives of Disease in Childhood. 2005;90(9):952-955 [Pubmed]
  6. 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]
  7. Kemp AM, Stoodley N, Cobley C, Coles L, Kemp KW. Apnoea and brain swelling in non-accidental head injury. Archives of Disease in Childhood. 2003;88(6):472-476, discussion 476 [Pubmed]
  8. Tzioumi D, Oates RK. Subdural hematomas in children under 2 years. Accidental or inflicted? A 10-year experience. Child Abuse and Neglect. 1998;22(11):1105-1112 [Pubmed]
  9. Maguire SM, Pickerd N, Farewell D, Mann MK, Tempest V, Kemp AM. Which clinical features distinguish inflicted from non-inflicted brain injury? A systematic review. Archives of Disease in Childhood. 2009;94(11):860-867 [Pubmed]


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