Non-accidental Trauma in Pediatric Patients: a Review of Epidemiology, Pathophysiology, Diagnosis and Treatment

Overview

Journal Transl Pediatr

Publisher AME Publishing Company

Specialty Pediatrics

Date 2016 Feb 3

PMID 26835337

Citations 29

Authors

Alexandra R Paul

Matthew A Adamo

Affiliations

Soon will be listed here.

Abstract

Non-accidental trauma (NAT) is a leading cause of childhood traumatic injury and death in the United States. It is estimated that 1,400 children died from maltreatment in the United States in 2002 and abusive head trauma (AHT) accounted for 80% of these deaths. This review examines the epidemiology and risk factors for NAT as well as the general presentation and required medical work up of abused children. In addition, potential algorithms for recognizing cases of abuse are reviewed as well as outcomes in children with NAT and potential neurosurgical interventions which may be required. Finally, the evidence for seizure prophylaxis in this population is addressed.

Citing Articles

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PMID: 39808274 DOI: 10.1007/s00247-024-06158-2.

Racial and Ethnic Disparities in Child Abuse Identification and Inpatient Treatment.

Salimi-Jazi F, Liang N, Huang Z, Tennakoon L, Rafeeqi T, Trickey A JAMA Netw Open. 2024; 7(12):e2451588.

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Non-accidental trauma in the setting of hemophilia A - A case report.

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Can Hemorrhagic Stroke Genetics Help Forensic Diagnosis in Pediatric Age (<5 Years Old)?.

Treves B, Sonnini E, La Russa R, Del Duca F, Ghamlouch A, De Matteis A Genes (Basel). 2024; 15(5.

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Ocular injuries among patients with major trauma in England and Wales from 2004 to 2021.

Bashir M, Bouamra O, Kirwan J, Lecky F, Bourne R Eye (Lond). 2024; 38(14):2761-2767.

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References

Lyman J, McGwin Jr G, Malone D, Taylor A, Brissie R, Davis G . Epidemiology of child homicide in Jefferson County, Alabama. Child Abuse Negl. 2003; 27(9):1063-73. DOI: 10.1016/s0145-2134(03)00166-2. View

Wainwright M . Timing is everything: whether and when to use continuous electroencephalograms in abusive head trauma comes into focus. Pediatr Crit Care Med. 2013; 14(7):726-8. DOI: 10.1097/PCC.0b013e3182976574. View

Oliver J . Successive generations of child maltreatment: social and medical disorders in the parents. Br J Psychiatry. 1985; 147:484-90. DOI: 10.1192/bjp.147.5.484. View

Roche A, Fortin G, Labbe J, Brown J, Chadwick D . The work of Ambroise Tardieu: the first definitive description of child abuse. Child Abuse Negl. 2005; 29(4):325-34. DOI: 10.1016/j.chiabu.2004.04.007. View

. Diagnostic imaging of child abuse. Pediatrics. 2009; 123(5):1430-5. DOI: 10.1542/peds.2009-0558. View

Oluigbo C, Wilkinson C, Stence N, Fenton L, McNatt S, Handler M . Comparison of outcomes following decompressive craniectomy in children with accidental and nonaccidental blunt cranial trauma. J Neurosurg Pediatr. 2012; 9(2):125-32. DOI: 10.3171/2011.11.PEDS09449. View

Hornor G . Physical abuse: Recognition and reporting. J Pediatr Health Care. 2005; 19(1):4-11. DOI: 10.1016/j.pedhc.2004.06.009. View

Tanner J, Dechert M, Frieden I . Growing up with a facial hemangioma: parent and child coping and adaptation. Pediatrics. 1998; 101(3 Pt 1):446-52. DOI: 10.1542/peds.101.3.446. View

Arndt D, Lerner J, Matsumoto J, Madikians A, Yudovin S, Valino H . Subclinical early posttraumatic seizures detected by continuous EEG monitoring in a consecutive pediatric cohort. Epilepsia. 2013; 54(10):1780-8. PMC: 4439105. DOI: 10.1111/epi.12369. View

10.

Hahn Y, Fuchs S, Flannery A, Barthel M, McLone D . Factors influencing posttraumatic seizures in children. Neurosurgery. 1988; 22(5):864-7. View

11.

Foster K, Recker M, Lee P, Bell M, Tyler-Kabara E . Factors associated with hemispheric hypodensity after subdural hematoma following abusive head trauma in children. J Neurotrauma. 2014; 31(19):1625-31. PMC: 4171388. DOI: 10.1089/neu.2014.3372. View

12.

Aaen G, Holshouser B, Sheridan C, Colbert C, McKenney M, Kido D . Magnetic resonance spectroscopy predicts outcomes for children with nonaccidental trauma. Pediatrics. 2010; 125(2):295-303. DOI: 10.1542/peds.2008-3312. View

13.

Agran P, Anderson C, Winn D, Trent R, Walton-Haynes L, Thayer S . Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age. Pediatrics. 2003; 111(6 Pt 1):e683-92. DOI: 10.1542/peds.111.6.e683. View

14.

Feldman K, Bethel R, Shugerman R, Grossman D, Grady M, Ellenbogen R . The cause of infant and toddler subdural hemorrhage: a prospective study. Pediatrics. 2001; 108(3):636-46. DOI: 10.1542/peds.108.3.636. View

15.

Altemeier 3rd W, OConnor S, Vietze P, Sandler H, Sherrod K . Antecedents of child abuse. J Pediatr. 1982; 100(5):823-9. DOI: 10.1016/s0022-3476(82)80604-5. View

16.

Green M, Lieberman G, Milroy C, Parsons M . Ocular and cerebral trauma in non-accidental injury in infancy: underlying mechanisms and implications for paediatric practice. Br J Ophthalmol. 1996; 80(4):282-7. PMC: 505449. DOI: 10.1136/bjo.80.4.282. View

17.

Adamo M, Drazin D, Smith C, Waldman J . Comparison of accidental and nonaccidental traumatic brain injuries in infants and toddlers: demographics, neurosurgical interventions, and outcomes. J Neurosurg Pediatr. 2009; 4(5):414-9. DOI: 10.3171/2009.6.PEDS0939. View

18.

Lane W, Rubin D, Monteith R, Christian C . Racial differences in the evaluation of pediatric fractures for physical abuse. JAMA. 2002; 288(13):1603-9. DOI: 10.1001/jama.288.13.1603. View

19.

Goldstein B, Kelly M, Bruton D, Cox C . Inflicted versus accidental head injury in critically injured children. Crit Care Med. 1993; 21(9):1328-32. DOI: 10.1097/00003246-199309000-00016. View

20.

Benedict M, White R, CORNELY D . Maternal perinatal risk factors and child abuse. Child Abuse Negl. 1985; 9(2):217-24. DOI: 10.1016/0145-2134(85)90014-6. View