Medicolegal issues in abusive head trauma for the pediatric neurosurgeon

Neurosurg Focus. 2020 Nov;49(5):E23. doi: 10.3171/2020.8.FOCUS20599.


The purpose of this article is to serve as a rational guide for the pediatric neurosurgeon in navigating common medicolegal issues that arise in the management of abusive head trauma (AHT). Many of these issues may be unfamiliar or unpleasant to surgeons focused on addressing disease. The authors begin with a brief history on the origins of the diagnosis of AHT and the controversy surrounding it, highlighting some of the facets of the diagnosis that make it particularly unique in pediatric neurosurgery. They then review some special medical considerations in these patients through the perspective of the neurosurgeon and provide several examples as illustration. The authors discuss how to appropriately document these cases in the medical record for expected legal review, and last, they provide an overview of the legal process through which the neurosurgeon may be called to provide testimony.

Keywords: AHT = abusive head trauma; SBS = shaken baby syndrome; abusive head trauma; legal documentation; medicolegal.

MeSH terms

  • Child
  • Child Abuse* / diagnosis
  • Craniocerebral Trauma* / surgery
  • Humans
  • Infant
  • Neurosurgeons
  • Neurosurgical Procedures
  • Shaken Baby Syndrome*