How to recognize and diagnose abusive head trauma in infants

Abusive head trauma (AHT) is complex to define for establishing proper diagnosis criteria. This observation complicates greatly the diagnosis process when faced with an infant in consultation.

This study aims at clarifying the main criteria to be considered during the medical examination and interview with the social worker.

An exhaustive literature survey was conducted to examine carefully the symptoms and signs as risk factors proposed to physicians.

An analysis of the data available in the literature was quite difficult due to the various methods and the lack of real controlled studies. However, this analysis did show that the initial clinical signs and symptoms that are most frequently encountered are not very specific and can lead to a large differential diagnosis where AHT is often omitted.

The presence or combination of symptoms, even not highly specific, associated to a lack of a precise alternative diagnosis, especially in children under the age of one, should bring specialist to ask for additional brain imaging exams. The risk factors should not be taken into account for the diagnosis.