Abusive head trauma: evidence, obfuscation, and informed management

Abstract

Abusive head trauma remains the major cause of serious head injury in infants and young children. A great deal of research has been undertaken to inform the recognition, evaluation, differential diagnosis, management, and legal interventions when children present with findings suggestive of inflicted injury. This paper reviews the evolution of current practices and controversies, both with respect to medical management and to etiological determination of the variable constellations of signs, symptoms, and radiological findings that characterize young injured children presenting for neurosurgical care.

Keywords: AHT = abusive head trauma; CPS = Child Protective Services; SBS = shaken baby syndrome; SDH = subdural hemorrhage; abusive head trauma; child abuse; infant; nonaccidental trauma; shaken baby; subdural hematoma; traumatic brain injury.