Occult Head Injury in High-Risk Abused Children

• Published in: Pediatrics (Evanston) 2003-06, Vol.111 (6), p.1382-1386
• Main Authors: Rubin, David M, Christian, Cindy W, Bilaniuk, Larissa T, Zazyczny, Kelly Ann, Durbin, Dennis R
• Format: Article
• Language: English
• Subjects: Abused children; Adult; Biological and medical sciences; CAT scans; Child; Child abuse & neglect; Child Abuse - diagnosis; Child Abuse - statistics & numerical data; Child, Preschool; Children & youth; Confidence Intervals; Craniocerebral Trauma - diagnosis; Craniocerebral Trauma - epidemiology; CT imaging; Diagnosis, Differential; Facial Injuries - diagnosis; Facial Injuries - epidemiology; Family Characteristics; Female; Head injuries; Humans; Infant; Infant, Newborn; Magnetic resonance imaging; Magnetic Resonance Imaging - statistics & numerical data; Male; Medical examination; Medical sciences; Medical screening; Neurologic Examination - statistics & numerical data; Pediatrics; Physical Examination - statistics & numerical data; Physiological aspects; Predictive Value of Tests; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Rib Fractures - diagnosis; Rib Fractures - epidemiology; Risk Factors; Single Parent - statistics & numerical data; Tomography, X-Ray Computed - statistics & numerical data; Victimology
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.111.6.1382

Head injury is the leading cause of death in abused children under 2 years of age. Evidence for establishing guidelines regarding screening for occult head injury in a neurologically asymptomatic child with other evidence of abuse is lacking. This is particularly important given that many children with acute inflicted head injury have evidence of old injury when they are diagnosed. The primary aim of this study was to estimate the prevalence of occult head injury in a high-risk sample of abused children with normal neurologic examinations. The secondary aim was to describe characteristics of this population. Children under 2 years of age admitted to an urban children's hospital between January 1998 and December 2001 with injuries suspicious for child abuse were eligible for this study if they had a normal neurologic examination on admission. Subjects were selected if they met 1 of the following "high-risk" criteria: rib fractures, multiple fractures, facial injury, or age