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Review
. 2014 Jul;3(3):195-207.
doi: 10.3978/j.issn.2224-4336.2014.06.01.

Non-accidental trauma in pediatric patients: a review of epidemiology, pathophysiology, diagnosis and treatment

Alexandra R Paul  1 , Matthew A Adamo  1
Affiliations
Review

Non-accidental trauma in pediatric patients: a review of epidemiology, pathophysiology, diagnosis and treatment

Alexandra R Paul et al. Transl Pediatr. 2014 Jul.

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.

Keywords: Non-accidental trauma (NAT); inflicted head trauma; shaken baby syndrome.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Radiographic findings commonly seen in non-accidental trauma (NAT). (A) A left frontoparietal epidural hematoma in a 9-month-old male after being dropped; (B) an acute left frontoparietal subdural hematoma in a 14-year-old male following an assault; (C) a small amount of traumatic subarachnoid hemorrhage in the right sylvian fissure in a 12-year-old male following assault; (D) a small left frontal contusion in a 31-day-old female who was dropped; (E) restricted diffusion in the left thalamus, splenium of the corpus callosum and bilateral occipital poles in a 14-year-old female; (F) right frontal epidural hemorrhage as well as bifrontal and right posteromedial parietal/occipital lobe hypodensity representing infarction in a 3-year-old male following abuse.
Figure 2
Figure 2
Work up for non-accidental trauma (NAT).
See this image and copyright information in PMC

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