Biochemical markers of brain injury: could they be used as diagnostic adjuncts in cases of inflicted traumatic brain injury?

• Published in: Child Abuse & Neglect 2004-07, Vol.28 (7), p.739-754
• Main Authors: Berger, Rachel Pardes, Kochanek, Patrick M, Pierce, Mary Clyde
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biochemistry; Biological and medical sciences; Biomarkers; Brain damage; Brain Injuries - diagnosis; Brain Injuries - etiology; Brain Injuries - metabolism; Child; Child abuse & neglect; Child Abuse - diagnosis; Child, Preschool; Female; Head injury; Humans; Infant; Inflicted childhood neurotrauma; Male; Medical sciences; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Shaken baby syndrome; Shaken Baby Syndrome - diagnosis; Victimology
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2004.01.007

Child abuse is the leading cause of serious traumatic brain injury (TBI) in infants and young children (Billmire & Myers, 1985; Bruce & Zimmerman, 1989). The incidence of serious or fatal inflicted traumatic brain injury (iTBI) in children < 1 year of age is approximately 1 in 3,300 ( Keenan et al., 2003); since many cases of iTBI are of mild or moderate severity, the incidence is probably significantly higher. Even at an incidence of 1 in 3,300, iTBI is as common as the incidence of cystic fibrosis (CF), the most common genetic recessive disease in the Caucasian population. Proper diagnosis of iTBI is difficult even for experienced and astute physicians because its presentation can be subtle and important historical data are often lacking. As a result, misdiagnosis is common and can have catastrophic medical consequences for patients and significant financial consequences for society ( Ewing-Cobbs et al., 1998; Jenny, Hymel, Pitzen, Reinert, & Hay, 1999). Unlike CF for which there are several well established screening tests, there are currently no diagnostic adjuncts to help physicians screen for possible iTBI.