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Other useful references

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.


  • Differential diagnoses for the clinical features seen in AHT (e.g. subdural haemorrhage) need to be considered (e.g. glutaric aciduria, coagulopathy, metabolic disorders etc) 1,2,3
  • The postulated association between immunisation and neuropathology was explored among 5,545 investigations; 37 underwent post-mortem and there was no association between vaccines administered and lesions found 4
  • The importance of identifying children with minor abusive injuries (sentinel injuries) to prevent further severe injury, including abusive head trauma, has been highlighted 5,6
  • There is increasing interest in the identification of a clinical decision rule or screening investigations which may indicate which children have sustained intracranial injury / AHT 7
  • There is ongoing debate as to the significance of pre-existing macrocephaly amongst infants who present with intracranial injury 8
  • There is a welcome expansion of the literature relating to long term outcomes in children who sustain AHT 9
  • Work continues to identify the biomechanics underlying shaking as a cause of intracranial injury 10,11. In addition studies of the biomechanics of falls are an important contribution to our understanding of AHT 12,13
  • Publications relating to perpetrator admissions may provide insight into the mechanism of injury in AHT 14

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  1. Gago LC, Wegner RK, Capone A Jr, Williams GA. Intraretinal hemorrhages and chronic subdural effusions: glutaric aciduria type 1 can be mistaken for shaken baby syndrome. Retina. 2003;23(5):724-726 [Pubmed citation only]
  2. Rutty GN, Smith CM, Malia RG. Late-form hemorrhagic disease of the newborn: a fatal case report with illustration of investigations that may assist in avoiding the mistaken diagnosis of child abuse. American Journal of Forensic Medicine and Pathology. 1999;20(1):48-51 [Pubmed]
  3. Hendrickson DJ, Knisely AS, Coulter K, Telander DG, Quan R, Ruebner BH, Leigh MJ. An inborn error of bile salt transport with features mimicking abusive head trauma. Child Abuse & Neglect. 2010;34(7):472-6 [Pubmed citation only]

  4. Rorke-Adams LB, Evans G, Weibel RE, Johann-Liang R. Neuropathology of vaccination in infants and children. Vaccine. 2011;29(47):8754-9 [Pubmed]

  5. Sheets LK, Leach ME, Koszewski IJ, Lessmeier BS, Nugent M, Simpson P. Sentinel injuries in infants evaluated for child physical abuse. Pediatrics. 2013;131(4):701-707. [Pubmed]

  6. 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]
  7. Kochanek PM, Berger RP, Fink EL, Au AK, Bay?r H, Bell MJ, Dixon CE, Clark RS. The potential for bio-mediators and biomarkers in pediatric traumatic brain injury and neurocritical care. Frontiers in Neurology. 2013;4:40 [Pubmed]

  8. McKeag H, Christian CW, Rubin D, Daymont C, Pollock AN, Wood J. Subdural hemorrhage in pediatric patients with enlargement of the subarachnoid spaces. Journal of Neurosurgery. Pediatrics. 2013;11(4):438-44 [Pubmed]

  9. Greiner MV, Lawrence AP, Horn P, Newmeyer AJ, Makoroff KL. Early clinical indicators of developmental outcome in abusive head trauma. Child's Nervous System. 2012;28(6):889-96 [Pubmed]

  10. Finnie JW, Blumbergs PC, Manavis J, Turner RJ, Helps S, Vink R, Byard RW, Chidlow G, Sandoz B, Dutschke J, Anderson RW. Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome). Journal of Clinical Neuroscience. 2012;19(8):1159-64 [Pubmed]

  11. Finnie JW, Blumbergs PC, Manavis J, Vink R. Pattern of cerebrospinal immediate early gene c-fos expression in an ovine model of non-accidental head injury. Journal of Clinical Neuroscience. 2013;20(12):1759-61 [Pubmed]

  12. Haney SB, Starling SP, Heisler KW, Okwara L. Characteristics of falls and risk of injury in children younger than 2 years. Pediatric Emergency Care. 2010;26(12):914-8 [Pubmed]

  13. Thompson A, Bertocci G, Pierce MC. Assessment of injury potential in pediatric bed fall experiments using an anthropomorphic test device. Accident; Analysis & Prevention. 2013;50:16-24 [Pubmed]

  14. Adamsbaum C, Grabar S, Mejean N, Rey-Salmon C. Abusive head trauma: judicial admissions highlight violent and repetitive shaking. Pediatrics. 2010;126(3):546-55 [Pubmed]


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