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Abusive head trauma in India: imaging raises the curtain
Hima Pendharkar1, Shumyla Jabeen1,2, Nupur Pruthi3
1Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Insights
Researchers identified 48 potential cases of abusive head trauma (AHT) in young children in Southern India. This study highlights the need for increased awareness and comprehensive evaluation of AHT in the region.
Area of Science:
- Pediatric Neuroimaging
- Forensic Pathology
- Public Health
Background:
- Abusive head trauma (AHT) is a significant concern in child abuse cases.
- Early identification and intervention are crucial for improving outcomes.
- Data on AHT in the Indian context is limited.
Purpose of the Study:
- To identify children with possible abusive head trauma (AHT) at a neurocentre in Southern India.
- To analyze the clinical, imaging, and fundus findings in suspected AHT cases.
- To emphasize the importance of AHT recognition in the Indian scenario.
Main Methods:
- Retrospective study of CT imaging in children aged one month to three years (January 2013 - May 2021).
- Analysis of demographics, clinical presentations, and fundus examinations.
- Review of skeletal surveys, chest X-rays, and CT spine imaging.
Main Results:
- Identified 48 cases of possible AHT.
- Subdural hemorrhage (SDH) observed in 42 cases, subdural effusion (SDE) in 5.
- Other findings included hypoxia, subarachnoid hemorrhage (SAH), parenchymal hematoma, and intraventricular hemorrhage (IVH).
Conclusions:
- Abusive head trauma (AHT) requires significant attention within the Indian healthcare system.
- Comprehensive workup is essential for diagnosis, prevention, and management.
- Further research and awareness campaigns are needed to address AHT effectively.
Abstract:
The purpose of the study was to identify children at our institute who possibly suffered abusive head trauma (AHT). A retrospective study of CT imaging of children between one month to three years of age between January 2013 and May 2021 was carried out at a dedicated neurocentre in Southern India. We identified 48 cases of possible AHT. The demographics, clinical features at presentation, imaging and fundus findings were analyzed. Imaging revealed subdural hemorrhage (SDH) in 42 and sub dural effusion (SDE) in 5 cases, one case had only hypoxia. The location of SDH was studied as was hypoxia underlying SDH, global hypoxia and ischemia. Cases of subarachnoid hemorrhage (SAH), parenchymal hematoma & intraventricular hemorrhage (IVH) were also noted. Skeletal survey, chest X-ray and CT spine were reviewed. AHT needs to be paid attention to in the Indian scenario. An extensive work up is required to substantiate the claim and to work on prevention & management of these cases subsequently.
