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01.11.2014 | Original Article

Head injury pattern in children can help differentiate accidental from non-accidental trauma

verfasst von: Jonathan P. Roach, Shannon N. Acker, Denis D. Bensard, Andrew P. Sirotnak, Frederick M. Karrer, David A. Partrick

Erschienen in: Pediatric Surgery International | Ausgabe 11/2014

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Abstract

Objectives

Our aim was to define the radiographic findings that help differentiate abusive head trauma (AHT) from accidental head injury.

Methods

Our trauma registry was queried for all children ≤5 years of age presenting with traumatic brain injury (TBI) from 1996–2011.

Results

Of 2,015 children with TBI, 71 % had accidental injury and 29 % had AHT. Children with AHT were more severely injured (ISS 22.1 vs 14.4; p < 0.0001) and had a higher mortality rate (15 vs 5 %; p < 0.0001). Patients with AHT had higher rates of diffuse axonal injury (14 vs 8 %; p < 0.0001) and subdural hemorrhage (76 vs 23 %; p < 0.0001). Children with accidental injury had higher rates of skull fractures (52 vs 21 %; p < 0.0001) and epidural hemorrhages (11 vs 3 %).

Conclusions

AHT occurred in 29 % of children and resulted in increased mortality rates. These children had higher rates of subdural hemorrhages and diffuse axonal injury. Physicians initially evaluating injured children must maintain a high index of suspicion for abuse in those who present with subdural hematoma or diffuse axonal injury.

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Titel: Head injury pattern in children can help differentiate accidental from non-accidental trauma
verfasst von: Jonathan P. Roach
Shannon N. Acker
Denis D. Bensard
Andrew P. Sirotnak
Frederick M. Karrer
David A. Partrick
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 11/2014
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-014-3598-3

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Head injury pattern in children can help differentiate accidental from non-accidental trauma