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Controlled Cortical Impact Model for Traumatic Brain Injury
05:30

Controlled Cortical Impact Model for Traumatic Brain Injury

Published on: August 5, 2014

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The association of subcortical brain injury and abusive head trauma

Katelyn M Even1, Kent P Hymel1, Veronica Armijo-Garcia2

  • 1Department of Pediatrics, Penn State College of Medicine, Penn State Health Children's Hospital, 600 University Drive, Hershey, PA 17033, USA.

Child Abuse & Neglect
|October 29, 2022
PubMed

Insights

Subcortical brain injury is strongly linked to abusive head trauma (AHT) in young children. This finding aids in diagnosing AHT, especially when combined with other injury indicators.

Area of Science:

  • Pediatric Neuroimaging
  • Child Abuse Pediatrics
  • Forensic Pathology

Background:

  • Abusive head trauma (AHT) presents significant diagnostic challenges in pediatrics.
  • Prior research suggested a link between subcortical brain injury and AHT.

Purpose of the Study:

  • To investigate the association between subcortical brain injury identified on neuroimaging and the diagnosis of AHT.
  • To determine if subcortical injury is a reliable indicator in diagnosing abusive head trauma.

Main Methods:

  • A secondary analysis of a de-identified, cross-sectional dataset was performed.
  • Data included children under 3 years old with acute traumatic brain injury (TBI) admitted to 18 pediatric intensive care units (PICUs).
  • Injury locations were categorized, with a focus on subcortical brain injury.

Main Results:

  • Subcortical injury was significantly associated with AHT diagnoses, both by physician impression (OR: 8.41) and defined criteria (OR: 5.99).
  • Children with subcortical injuries were more likely to have other traumatic injuries (e.g., rib fractures, retinal hemorrhages) and severe complications (e.g., respiratory compromise, seizures, encephalopathy).
  • Caregiver reports inconsistent with the child's motor skills decreased as injury depth increased.

Conclusions:

  • Subcortical injury is a key indicator associated with AHT diagnoses.
  • The presence of subcortical injury, alongside other traumatic injuries and clinical signs, is crucial for the complex diagnostic process of AHT.
  • This finding supports the consideration of subcortical injury as a significant component in evaluating suspected abusive head trauma.
Abstract

Keywords:
Abusive head traumaDiagnosisTraumatic brain injury

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