The “New Science” of Abusive Head Trauma

Claims that new science is changing accepted medical opinion about abusive head injury have been made frequently in the media, legal publications, and in legal cases involving abusive head trauma (AHT). This review analyzes recently published scientific articles about AHT to determine whether this n...

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Bibliographic Details
Published in:International journal on child maltreatment : research, policy and practice policy and practice, 2019-07, Vol.2 (1-2), p.1-16
Main Authors: Lindberg, Daniel M., Dubowitz, Howard, Alexander, Randell C., Reece, Robert M.
Format: Article
Language:English
Subjects:
Autopsies
Child Abuse
Child abuse & neglect
Child mortality
Child Well-being
Children
Children & youth
Criminals
Educational Equipment
Etiology
Falls
Fatalities
Head injuries
Hematoma
Hospitals
Individualized Instruction
Injuries
Literature Reviews
Medical Evaluation
Morbidity
Original Paper
Physical Examinations
Physicians
Records (Forms)
Science
Scientific Research
Social Sciences
Trauma
Young Children
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Summary:Claims that new science is changing accepted medical opinion about abusive head injury have been made frequently in the media, legal publications, and in legal cases involving abusive head trauma (AHT). This review analyzes recently published scientific articles about AHT to determine whether this new information has led to significant changes in the understanding, evaluation, and management of children with suspected AHT. Several specific topics are examined as follows: serious or fatal injuries from short falls, specificity of subdural hematoma for severe trauma, biomechanical explanations for findings, the specificity of retinal hemorrhages, the possibility of cerebral sinus thrombosis presenting with signs similar to AHT, and whether vaccines can produce such findings. We conclude (a) that the overwhelming weight of recent data does not change the fundamental consensus, (b) that abusive head trauma is a significant source of morbidity and mortality in children, (c) that subdural hematomas and severe retinal hemorrhages are commonly the results of severe trauma, (d) that these injuries should prompt an evaluation for abuse when identified in young children without a history of such severe trauma, and (e) that short falls, cerebral sinus thrombosis, and vaccinations are not plausible explanations for findings that raise concern for abusive head trauma.
ISSN:2524-5236
2524-5244
DOI:10.1007/s42448-019-00021-w