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A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
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Pediatric Abusive Head Trauma: A Systematic Review.

Aniello Maiese1,2, Francesca Iannaccone1, Andrea Scatena1

  • 1Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy.

Diagnostics (Basel, Switzerland)
|April 30, 2021
PubMed
Summary

Diagnosing abusive head trauma (AHT) in children is challenging due to the lack of definitive signs. This review examines evidence for best practices in AHT diagnosis, integrating clinical, radiological, and autopsy findings.

Keywords:
abusive head traumaforensic pathologypost-mortem CTretinal hemorrhageshaken baby syndrome

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Area of Science:

  • Pediatrics
  • Forensic Pathology
  • Radiology

Background:

  • Abusive head trauma (AHT) is frequently misdiagnosed in pediatric cases.
  • The absence of pathognomonic signs complicates AHT diagnosis.
  • Accurate diagnosis of AHT presents significant medico-legal challenges.

Purpose of the Study:

  • To review current scientific evidence on diagnosing abusive head trauma (AHT).
  • To identify best practices for AHT diagnosis.
  • To evaluate diagnostic tools for AHT in children.

Main Methods:

  • Review of scientific literature on AHT diagnosis.
  • Evaluation of circumstantial evidence and clinical history.
  • Assessment of postmortem radiological examinations (CT, MRI).
  • Analysis of autopsy findings, including ocular and brain histology.

Main Results:

  • No single pathognomonic sign exists for diagnosing AHT.
  • Circumstantial evidence, clinical history, and autopsy findings are crucial.
  • Postmortem imaging (CT, MRI) and histological examination aid diagnosis.
  • Correlation of in vivo symptoms with autopsy findings is important.

Conclusions:

  • A comprehensive approach integrating multiple diagnostic modalities is essential for accurate AHT diagnosis.
  • Reliable diagnostic tools are critical for addressing the medico-legal aspects of AHT.
  • Histological examination of the eye and brain, correlated with clinical data, enhances diagnostic certainty.