Head Injury Pattern in Children Can Help Differentiate Accidental from Non-accidental Trauma

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2014 Sep 26

PMID 25252922

Citations 10

Authors

Jonathan P Roach

Shannon N Acker

Denis D Bensard

Andrew P Sirotnak

Frederick M Karrer

David A Partrick

Affiliations

Soon will be listed here.

Abstract

Objectives: Our aim was to define the radiographic findings that help differentiate abusive head trauma (AHT) from accidental head injury.

Methods: Our trauma registry was queried for all children ≤5 years of age presenting with traumatic brain injury (TBI) from 1996-2011.

Results: Of 2,015 children with TBI, 71% had accidental injury and 29% had AHT. Children with AHT were more severely injured (ISS 22.1 vs 14.4; p < 0.0001) and had a higher mortality rate (15 vs 5%; p < 0.0001). Patients with AHT had higher rates of diffuse axonal injury (14 vs 8%; p < 0.0001) and subdural hemorrhage (76 vs 23%; p < 0.0001). Children with accidental injury had higher rates of skull fractures (52 vs 21%; p < 0.0001) and epidural hemorrhages (11 vs 3%).

Conclusions: AHT occurred in 29% of children and resulted in increased mortality rates. These children had higher rates of subdural hemorrhages and diffuse axonal injury. Physicians initially evaluating injured children must maintain a high index of suspicion for abuse in those who present with subdural hematoma or diffuse axonal injury.

Citing Articles

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