Topics Discussed: abuse, neglect, violence; child abuse; craniocerebral trauma; neglect of child; pediatric head injury; physical abuse of child.
Sections: Differential Diagnosis of Child Abuse, Ancillary Studies, Neglect, Management, Conclusion, References.
Excerpt:"Abusive head injury is the leading cause of morbidity and mortality in physically abused children. Caffey, in a landmark article published in 1972, described the classic triad associated with inflicted neurotrauma: subdural hemorrhages, retinal hemorrhages, and metaphyseal fractures.17 Since that time, much work has been done to enhance the recognition and to improve the understanding of the biomechanics and pathophysiology of inflicted head injury. Despite these efforts, controversy still exists regarding the mechanisms of injury, how patients present, and how specific certain injuries are for abuse. Over the years, many terms have been used to describe inflicted head injury, including shaken baby syndrome (SBS), shaken-impact syndrome, and abusive head injury. Because both shaking and blunt trauma to the head can result in the injuries described by Caffey, and because hypoxic ischemic injury is a recognized contributor to the brain injury seen in abused infants, the current recommendation is to refer to the injury with an inclusive term that does not specify the exact mechanism of injury, such as inflicted neurotrauma or abusive head trauma (AHT)...."
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