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Lucid interval in abusive head trauma: a systematic review
Clémentine Aucouturier1, Lise Pestourie2, Céline Guilbeau-Frugier1
1Medicolegal Institute, CHRU TOULOUSE, Purpan Hospital, Place du Dr Joseph Baylac, 31300 Toulouse, France.
Child Abuse & Neglect
|July 27, 2026
Summary
Abusive head trauma (AHT) symptoms often appear immediately, though early, nonspecific signs may be missed. This finding aids in determining the timing of AHT in infants.
Area of Science:
- Pediatric Medicine
- Forensic Medicine
- Neurology
Background:
- Abusive head trauma (AHT) is a leading cause of infant injury, posing diagnostic challenges due to lack of history and limited witnesses.
- Determining the precise timing of AHT is critical for identifying perpetrators, but the concept of a "lucid interval" is debated.
Purpose of the Study:
- To systematically review the literature regarding the presence or absence of a lucid interval following abusive head trauma (AHT).
Main Methods:
- A systematic literature search was conducted across MEDLINE, EMBASE, and Google Scholar up to 2026.
- Included studies focused on children evaluated for AHT with reported trauma timing and symptom onset.
Main Results:
- Sixteen studies were analyzed, varying in definitions of the lucid interval.
- Some studies defined the interval by any symptom (e.g., vomiting, lethargy), while others focused on specific neurological signs (e.g., seizures).
Conclusions:
- Evidence suggests symptoms typically manifest immediately after AHT, though initial nonspecific signs may be overlooked.
- Understanding symptom onset timing, even for subtle signs, can assist experts in AHT investigations.
