Related Experiment Video

Updated: May 22, 2026

A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
07:01

A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)

Published on: February 7, 2025

Risk factors for mortality in children with abusive head trauma

Steven L Shein1, Michael J Bell, Patrick M Kochanek

  • 1Department of Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15260, USA. drstevenshein@gmail.com

The Journal of Pediatrics
|May 15, 2012
PubMed

Insights

Abusive head trauma in children is linked to higher mortality with low initial Glasgow Coma Scale (GCS) scores and specific injuries like retinal hemorrhage. Identifying these risk factors is crucial for improving care.

Area of Science:

  • Pediatric Medicine
  • Neurology
  • Forensic Pathology

Background:

  • Abusive head trauma (AHT) is a severe form of child maltreatment.
  • Identifying mortality risk factors in AHT is critical for clinical management and research.

Purpose of the Study:

  • To identify risk factors for in-hospital mortality in a large cohort of children diagnosed with abusive head trauma.

Main Methods:

  • Retrospective analysis of 386 children with AHT across four pediatric centers.
  • Bivariate and multivariable logistic regression models were used.
  • Initial Glasgow Coma Scale (GCS) ≤ 8 defined severe AHT.

Main Results:

  • Low initial GCS scores (3 or 4-5) significantly increased mortality risk.
  • Retinal hemorrhage, intraparenchymal hemorrhage, and cerebral edema were independently associated with mortality.
  • Chronic subdural hematoma was associated with survival.

Conclusions:

  • Initial GCS score, retinal hemorrhage, intraparenchymal hemorrhage, and cerebral edema are key independent predictors of mortality in AHT.
  • Understanding these risk factors can guide clinical interventions and improve outcomes for affected children.
Abstract

More Related Videos

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury09:49

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury

Published on: January 20, 2023

Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury05:01

Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury

Published on: August 16, 2019

Related Concept Videos

Bullying02:04

Bullying

A modern form of aggression is bullying. As you learn in your study of child development, socializing and playing with other children is beneficial for children’s psychological development. However, as you may have experienced as a child, not all play behavior has positive outcomes. Some children are aggressive and want to play roughly. Other children are selfish and do not want to share toys. One form of negative social interactions among children that has become a national concern is bullying.
Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Attention-Deficit/Hyperactivity Disorder01:30

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...