Update on abusive head trauma

Curr Opin Pediatr. 2015 Jun;27(3):308-14. doi: 10.1097/MOP.0000000000000207.


Purposes of review: This article provides an update on abusive head trauma (AHT), focusing on new developments most salient to the emergency medicine clinician, including epidemiology, clinical recognition, diagnostic work-up, management of neurologic injury, and public health implications.

Recent findings: The recent literature has focused on honing the clinician's ability to recognize AHT and its immediate sequelae, to more accurately distinguish between abusive and accidental head injuries by patterns of neuroimaging and retinal hemorrhages, and to appreciate the long-term impacts. Specifically, both a clinical prediction rule and biomarker show promise, and new research advocates for the early identification of subclinical seizures as well as cervical spine injuries.

Summary: The emergency medicine provider must be able to recognize and manage children who may have AHT and to appreciate when the diagnostic findings warrant consultation with a child protection team. These authors summarize the recent and notable advances in our understanding of AHT.

Publication types

  • Review

MeSH terms

  • Accidents / statistics & numerical data*
  • Brain Injuries / diagnosis*
  • Brain Injuries / etiology
  • Brain Injuries / pathology
  • Cervical Vertebrae / injuries
  • Cervical Vertebrae / pathology*
  • Child
  • Child Abuse / diagnosis*
  • Child Abuse / prevention & control
  • Child, Preschool
  • Craniocerebral Trauma / complications
  • Craniocerebral Trauma / diagnosis*
  • Craniocerebral Trauma / pathology
  • Decision Support Techniques
  • Diagnosis, Differential
  • Evidence-Based Medicine
  • Humans
  • Magnetic Resonance Imaging
  • Neuroimaging / methods
  • Practice Guidelines as Topic
  • Retinal Hemorrhage / diagnosis*
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / pathology
  • Subarachnoid Hemorrhage / diagnosis*
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / pathology