Related Experiment Video
Updated: Sep 5, 2025
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Factors associated with poor neurological outcome in children after abusive head trauma: A multicenter retrospective
Fanny Regeffe1, Mathilde Chevignard2, Anne Millet1
1Pediatric Intensive Care Unit, Grenoble-Alpes University Hospital, Grenoble, France.
Insights
Abusive Head Trauma (AHT) causes significant infant brain injury. Cardiorespiratory arrest and low Glasgow Coma Score at admission predict poor neurological outcomes in children with AHT.
Area of Science:
- Pediatric Neurology
- Neurotrauma
- Child Abuse Pediatrics
Background:
- Abusive Head Trauma (AHT) is the primary cause of brain injury in infants.
- Infants are particularly vulnerable to severe, long-term neurological deficits following AHT.
Purpose of the Study:
- To characterize a cohort of pediatric patients diagnosed with AHT.
- To identify early clinical indicators associated with adverse neurological outcomes in infants with AHT.
Main Methods:
- A multicenter retrospective study included 117 infants under one year old admitted to a Pediatric Intensive Care Unit (PICU) with suspected or confirmed AHT.
- Neurological outcomes were assessed using the Pediatric Overall Performance Category (POPC) score at hospital discharge and a 2-year follow-up.
- Data were collected over an 8-year period (January 2012 to December 2020).
Main Results:
- Of 117 patients, 85% completed a 2-year follow-up.
- At discharge and 2-year follow-up, 52% and 44% of children, respectively, had moderate to severe disabilities (POPC score ≥ 2).
- Common long-term disabilities included neurodevelopmental issues (35%), hyperactivity disorder (33%), and epilepsy (31%).
- Cardiorespiratory arrest and a low Glasgow Coma Score upon admission were identified as significant predictors of poor neurological outcomes.
Conclusions:
- Children with AHT exhibit a broad spectrum of neurological disabilities.
- Prompt, multidisciplinary follow-up care is essential for mitigating the long-term impact of AHT-related neurological deficits.
Background:
Abusive Head Trauma (AHT) remains the leading cause of brain injury in infants.
Objective:
This study aims to describe a cohort of patients with AHT and identify early risk factors associated with poor neurological outcome.
Participants And Setting:
Children under one year old admitted to a Pediatric Intensive Care Unit (PICU) with a suspected or confirmed diagnosis of AHT were included. Neurological outcome was assessed by the Pediatric Overall Performance Category score (POPC) at discharge from the hospital and at two years of follow-up.
Methods:
A multicentre retrospective study was conducted over 8 years (from January 2012 to December 2020).
Results:
A total of 117 patients (mean age 4.3 (+/- 2.5) months, 61 % boys) from three PICUs were included. A total of 99 (85 %) patients completed a 2-year follow-up. Sixty-one (52 %) and 47 (40 %) children with AHT had a POPC (pediatric overall performance category) score ≥ 2 at discharge from ICU and discharge from hospital, respectively (meaning they had at least a moderate disability). Fifty-one (44 %) had a POPC score ≥ 2 at 2-year follow-up, including 19 patients (19 %) with severe disabilities. The main neurological disabilities were neurodevelopmental (n = 38, 35 %), hyperactivity disorder (n = 36, 33 %) and epilepsy (n = 34, 31 %). After analysis according to the hierarchical model, the occurrence of a cardiorespiratory arrest and a low Glasgow Coma Score at admission stand out as factors of poor neurological outcome.
Conclusion:
This study highlights the wide range of neurological disabilities in children with AHT. Early and multidisciplinary follow-up is crucial to limit the impact of neurological disability.
