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Abusive head trauma: two cases and mini-review of the current literature
Sıtkı Tıplamaz1, Abdülvehhap Beygirci2, Murat Nihat Arslan3
1The Council of Forensic Medicine, Gümüşhane Directorate Branch of Forensic Medicine, Gümüşhane, Turkey.
Insights
Abusive head trauma (AHT) is a leading cause of fatal pediatric head injuries. Early diagnosis and a multidisciplinary approach are crucial for managing AHT and improving outcomes for affected children.
Area of Science:
- Pediatric Traumatology
- Forensic Pathology
- Child Abuse Prevention
Background:
- Abusive head trauma (AHT) is the primary cause of fatal head injuries in children.
- AHT accounts for over half of serious or fatal traumatic brain injuries in children under two.
- Long-term consequences of AHT include death, neurological deficits, and developmental disorders.
Observation:
- Two cases of AHT in 7-month-old infants are presented.
- Clinical findings were inconsistent with initial histories in both cases.
- Detailed workups and follow-up histories confirmed the diagnosis of AHT.
Findings:
- One infant case resulted in death.
- The second infant case was discharged with significant neurological deficits.
- Discrepancies between history and clinical presentation are characteristic of AHT.
Implications:
- A multidisciplinary approach is essential for effective AHT prevention, diagnosis, and treatment.
- Early identification and intervention can mitigate severe long-term outcomes.
- Understanding AHT is critical for forensic analysis and child protection.
Background:
Abusive head trauma (AHT) is the leading cause of fatal head injuries and are responsible for more than half of serious or fatal traumatic brain injury cases in children younger than 2 years of age. Long-term outcomes of AHT are death, spastic hemiplegia or quadriplegia, intractable epilepsy, microcephaly with corticosubcortical atrophy, visual impairment, language disorder and cognitive, behavioral and sleep disorders.
Cases:
Herein we present two cases of AHT (7-month-old boy, 7-month-old girl) according to forensic analysis, and discuss them in light of the current literature and share our experience. Inconsistency between the presenting history and the clinical findings were typical in both cases; follow-up histories and detailed workup revealed the diagnosis of AHT. The first case was deceased; the second case was discharged with neurological deficits.
Conclusion:
A multidisciplinary approach is critical for the prevention, diagnosis and treatment of AHT.
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