Advances and Future Directions of Diagnosis and Management of Pediatric Abusive Head Trauma: A Review of the Literature

Frontiers in Neurology
A M Iqbal O'MearaNikki Miller Ferguson

Abstract

Abusive head trauma (AHT) is broadly defined as injury of the skull and intracranial contents as a result of perpetrator-inflicted force and represents a persistent and significant disease burden in children under the age of 4 years. When compared to age-matched controls with typically single occurrence accidental traumatic brain injury (TBI), mortality after AHT is disproportionately high and likely attributable to key differences between injury phenotypes. This article aims to review the epidemiology of AHT, summarize the current state of AHT diagnosis, treatment, and prevention as well as areas for future directions of study. Despite neuroimaging advances and an evolved understanding of AHT, early identification remains a challenge for contemporary clinicians. As such, the reported incidence of 10-30 per 100,000 infants per year may be a considerable underestimate that has not significantly decreased over the past several decades despite social campaigns for public education such as "Never Shake a Baby." This may reflect caregivers in crisis for whom education is not sufficient without support and intervention, or dangerous environments in which other family members are at risk in addition to the child. Acute management spec...Continue Reading

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Citations

Jan 19, 2021·Disability and Rehabilitation·Aimee E MileyShari L Wade
Nov 10, 2020·Korean Journal of Neurotrauma·Won Jae LeeSoo Han Yoon
Jan 2, 2021·World Journal of Critical Care Medicine·Kamal AbulebdaPaul R Barach
May 18, 2021·Pediatric Radiology·Rahul M NikamArabinda K Choudhary

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Methods Mentioned

BETA
sedation

Software Mentioned

PediBIRN
PredAHT

Related Concepts

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

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