Abusive Head Trauma.pmd

While accidental trauma is the most common cause of death in childhood, abusive head trauma is the most common cause of traumatic death in infancy. The incidence of abusive head trauma in the United States is estimated to be 15 per 1000 children each year, though this may be an underestimation. Nearly 25% of children under 2 years of age who are hospitalized for head trauma have been abused. There are several clinical and radiological features that are helpful in distinguishing accidental from abusive head trauma in young infants, such as retinal hemorrhages, which are present in 60% to 95% of patients with abusive head trauma. Computed tomographic scanning (CT) is the most rapid, reliable tool in the diagnosis of abusive head trauma. Acute subdural and subarrachnoid hemorrhage, the most common brain injuries seen in children with abusive head trauma, can be readily appreciated on CT by experienced clinicians. Long-term outcome of survivors of abusive head trauma tends to be poor, and is dependent on the severity of symptoms on initial presentation. Such clinical features are helpful in distinguishing accidental from abusive head trauma in young children.