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A Systematic Review of Pediatric Abusive Head Trauma: What a Surgeon Needs to Know Before Using a Knife
Jitender Chaturvedi1, Divakar Goyal2, Ritu S3,4
1Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Insights
Abusive head trauma (AHT) in young children causes severe injuries like blindness and developmental delays. This review synthesizes 58 studies on AHT
Area of Science:
- Pediatric Traumatology
- Child Abuse and Neglect
- Radiology and Imaging
Background:
- Abusive head trauma (AHT) involves inflicted blunt impact or shaking injuries in children under five.
- AHT can lead to severe, long-term consequences including blindness and developmental delays.
- Understanding AHT's clinical and radiological aspects is crucial for timely diagnosis and intervention.
Purpose of the Study:
- To review and synthesize current literature on abusive head trauma (AHT).
- To consolidate information on risk factors, clinical features, extracranial injuries, and radiological findings in AHT.
- To provide clinicians and surgeons with updated knowledge on AHT management and outcomes.
Main Methods:
- Systematic literature search of PubMed, Cochrane, Embase, and Google Scholar (2001-2021).
- Data extraction by two independent reviewers.
- Bias assessment using the Joanna Briggs Institute (JBI) critical appraisal tool.
Main Results:
- Fifty-eight studies were included in the review.
- Studies covered risk factors (20), clinical features (28), extracranial injuries (28), radiological procedures/abnormalities (26), and outcomes (31).
- Key findings highlight patterns of injury, diagnostic imaging techniques, and prognostic indicators.
Conclusions:
- This review consolidates essential information on the clinical and radiological aspects of AHT.
- It emphasizes the importance of recognizing patterns of injury and utilizing advanced imaging.
- Findings aim to improve the diagnosis, management, and understanding of outcomes for AHT.
Abstract:
Abusive head trauma (AHT) has been defined as an injury to the skull or intracranial contents of a baby or young child (age less than five years) due to inflicted blunt impact and/or forceful shaking. It has a substantial impact, such as blindness and severe developmental delay in the short and long run. We searched PubMed, Cochrane, Embase, and Google Scholar databases for articles published between January 2001 and December 2021. Two independent reviewers extracted the data from the included studies. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the bias in the studies included. A total of 58 studies were included for review. Out of them, 20 studies looked at the risk factors, 28 studies addressed the clinical features, 28 publications described extracranial injuries, 26 papers discussed radiological procedures and various abnormalities, and 31 studies discussed outcomes. We hope to share with clinicians and surgeons the information learned by conducting this review about clinical aspects, patterns of injuries to extra-cranial systems among AHT, radiographic technologies, and upcoming advancements in radiological aspects and overall outcomes of AHT.
