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Related Experiment Video

Updated: Mar 1, 2026

A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
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Pediatric abusive head trauma and stroke.

Nickalus R Khan1, Brittany D Fraser2, Vincent Nguyen1

  • 1Department of Neurosurgery and.

Journal of Neurosurgery. Pediatrics
|June 3, 2017
PubMed
Summary

Abusive head trauma (AHT) in children is often complicated by cerebrovascular accidents (CVA), leading to increased healthcare utilization, surgical interventions, and a higher mortality risk. Identifying stroke in AHT cases signifies a more severe injury with poorer outcomes.

Keywords:
ACA = anterior cerebral arteryADC = apparent diffusion coefficientAHT = abusive head traumaAICA = anterior inferior cerebellar arteryCARES = Neurosurgery and the Child Advocacy Resource and Evaluation ServicesCVA = cerebrovascular accidentDWI = diffusion-weighted imagingLBCH = Le Bonheur Children’s HospitalLOS = length of stayMCA = middle cerebral arteryNAT = nonaccidental traumaPCA = posterior cerebral arteryPICA = posterior inferior cerebellar arterySCA = superior cerebellar arterycerebrovascular accidenthemisphericnonaccidental traumapediatric abusive head injurystrokesubdural hematoma

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Area of Science:

  • Pediatric Neurology
  • Trauma Surgery
  • Neuroradiology

Background:

  • Abusive head trauma (AHT) is a significant cause of pediatric injury.
  • Cerebrovascular accident (CVA) is a known consequence of AHT, but its impact on outcomes is not fully understood.

Purpose of the Study:

  • To evaluate the association between CVA and healthcare utilization, including surgical intervention and mortality, in children with AHT.
  • To determine if CVA is a predictor of injury severity and adverse outcomes in pediatric AHT cases.

Main Methods:

  • Retrospective observational study of children with AHT at Le Bonheur Children's Hospital (2009-2016).
  • Comparison of demographic, clinical, radiological, cost, and readmission data between children with and without CVA.
  • Analysis of injury severity, neurosurgical procedures, hospital length of stay, charges, and mortality.

Main Results:

  • 28% of 282 AHT patients had one or more CVA.
  • Children with CVA had significantly longer hospital stays (11 vs. 3 days), higher total charges ($13.8M vs. $6.6M), and increased mean charges per patient ($174.7K vs. $32.5K).
  • Mortality was substantially higher in the CVA cohort (25% vs. 1%), with a 30% readmission rate requiring further neurosurgical intervention.

Conclusions:

  • CVA in pediatric AHT patients indicates a severe injury with significantly increased healthcare utilization and mortality.
  • Stroke is a critical predictor of outcomes in AHT, suggesting a need for subcategorization of injury grades.
  • The findings underscore the severity of AHT-associated CVAs and their impact on patient management and prognosis.