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Acute presentation of abusive head trauma

Luke Hartman1, H Michelle Greene1

  • 1Division of Child and Family Advocacy, Department of Pediatrics, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205.

Seminars in Pediatric Neurology
|July 4, 2024
PubMed

Insights

Abusive head trauma, a leading cause of child abuse deaths, requires rapid identification due to subtle symptoms. This article provides a framework for assessing abusive head trauma to improve diagnosis and victim safety.

Area of Science:

  • Pediatrics
  • Forensic Medicine
  • Child Abuse Research

Background:

  • Child abuse is a significant cause of child morbidity and mortality in the U.S.
  • Abusive head trauma (AHT), previously known as shaken baby syndrome, is the primary cause of fatal physical child abuse.
  • The diverse and subtle clinical presentations of AHT often lead to diagnostic delays and missed cases.

Purpose of the Study:

  • To present a framework for the assessment of abusive head trauma (AHT).
  • To provide information on common AHT presentations, injuries, and differential diagnoses.
  • To enhance recognition and safety planning for victims of AHT.

Main Methods:

  • Review of clinical presentations, medical history, and physical examination findings in AHT.
  • Discussion of laboratory evaluations and imaging modalities for AHT diagnosis.
  • Exploration of differential diagnoses for symptoms mimicking AHT.

Main Results:

  • AHT presents with a wide spectrum of symptoms, from severe neurological deficits to subtle signs like vomiting.
  • Accurate diagnosis relies on a comprehensive approach including history, physical exam, labs, and imaging.
  • Identifying underlying non-traumatic causes is crucial during the evaluation.

Conclusions:

  • A strong understanding of AHT is essential for healthcare providers.
  • Improved recognition of AHT can lead to better safety planning for child abuse victims.
  • This framework aims to improve the identification and management of abusive head trauma.

Keywords:
non-accidental traumaphysical abuseretinal hemorrhageshaken baby syndromesubdural hemorrhage

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