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Abusive head trauma

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https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#1
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422325/the-way-forward-in-addressing-abusive-head-trauma-in-infants-current-perspectives-from-sweden
#2
EDITORIAL
Steven Lucas, Anna Bärtås, Anna-Karin Edstedt Bonamy, Lisa Törnudd, Peter Wide, Gabriel Otterman
No abstract text is available yet for this article.
April 19, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28418820/case-241-hemiparkinsonism-hemiatrophy-spect-with-99m-tc-trodat-1-and-muscle-mr-imaging-abnormalities
#3
Thiago Cardoso Vale, Flávia Cristina de Lima Pinto, José Luiz Pedroso, Marília Alves Dos Reis, Ilza Rosa Batista, Rodrigo Affonseca Bressan, René Leandro Magalhães Rivero, Renato Adam Mendonça, Orlando G Barsottini
History A 43-year-old right-handed man presented with a history of progressive mild left-sided weakness and slowness of movements. Symptoms began 4 years earlier, and the patient noticed a progressive decline in his daily routine due to gait difficulties in the past year. There was no history of head trauma, surgery, drug therapy, smoking, or alcohol abuse, nor was there any relevant family history. Examination revealed normal cognition (29 of 30 points on the Mini-Mental State Examination and 27 of 30 points on the Montreal Cognitive Assessment) and normal cerebellar, sensory, cranial nerve, and autonomic function...
May 2017: Radiology
https://www.readbyqxmd.com/read/28399448/apparent-diffusion-coefficient-adc-of-the-vitreous-humor-and-susceptibility-weighted-imaging-swi-of-the-retina-in-abused-children-with-retinal-hemorrhages
#4
Misun Hwang, Samuel S Shin, Matthew A Thimm, Anish Ghodadra, Christin L Sylvester, Ken Nischal, Ashok Panigrahy, Giulio Zuccoli
This study speculated that the apparent diffusion coefficient (ADC) of the vitreous humor might be altered in the setting of abusive head trauma (AHT) with retinal hemorrhages (RH). Fourty-four subjects were analyzed (n=20 AHT cases; n=24 controls). There was no statistically significant difference in normalized ADC values between the cases and controls (-0.14 and -0.08 respectively, p=0.46), but analysis of RH by susceptibility weighted imaging (SWI) compared to dilated funduscopic exam demonstrated statistically significant correlation (p=0...
April 3, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28395008/derivation-and-validation-of-a-serum-biomarker-panel-to-identify-infants-with-acute-intracranial-hemorrhage
#5
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
April 10, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28389927/post-mortem-imaging-of-the-infant-and-perinatal-dura-mater-and-superior-sagittal-sinus-using-optical-coherence-tomography
#6
Emma C Cheshire, Roger D G Malcomson, Shiju Joseph, Asif Adnan, David Adlam, Guy N Rutty
Infants and young children are likely to present with subdural haemorrhage (SDH) if they are the victims of abusive head trauma. In these cases, the most accepted theory for the source of bleeding is the bridging veins traversing from the surface of the brain to the dura mater. However, some have suggested that SDH may result from leakage of blood from a dural vascular plexus. As post-mortem examination of the bridging veins and dura is challenging, and imaging modalities such as magnetic resonance and computed tomography do not have the resolution capabilities to image small blood vessels, we have trialled the use of intravascular and benchtop optical coherence tomography (OCT) systems for imaging from within the superior sagittal sinus (SSS) and through the dura during five infant/perinatal autopsies...
April 7, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28341000/arterial-spin-labeling-perfusion-imaging-of-children-with-subdural-hemorrhage-perfusion-abnormalities-in-abusive-head-trauma
#7
Alex Mun-Ching Wong, Chih-Hua Yeh, Ho-Ling Liu, Tai-Wei Wu, Kuang-Lin Lin, Huei-Shyong Wang, Cheng-Hong Toh
BACKGROUND AND PURPOSE: Perfusion abnormalities have not been well described in children with subdural hemorrhage (SDH). We investigated whether patients with abusive head trauma (AHT+) had more perfusion abnormalities than those without (AHT-). MATERIALS AND METHODS: We reviewed the perfusion MR studies of 12 infants with SDH and 21 controls. The perfusion images were obtained using a pseudo-continuous arterial spin-labeling sequence with volumetric fast spin-echo readout...
March 21, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28325786/impact-on-hospital-resources-of-systematic-evaluation-and-management-of-suspected-nonaccidental-trauma-in-patients-less-than-4-years-of-age
#8
Bethann M Pflugeisen, Mauricio A Escobar, Dustin Haferbecker, Yolanda Duralde, Elizabeth Pohlson
OBJECTIVE: There has been an increasing movement worldwide to create systematic screening and management procedures for atypical injury patterns in children with the hope of better detecting and evaluating nonaccidental trauma (NAT). A legitimate concern for any hospital considering implementation of a systematic evaluation process is the impact on already burdened hospital resources. We hypothesized that implementation of a guideline that uses red flags related to history, physical, or radiologic findings to trigger a standardized NAT evaluation of patients <4 years would not negatively affect resource utilization at our level II pediatric trauma center...
March 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28304222/letter-to-the-editor-subdural-collections-and-abusive-head-trauma
#9
Catherine Adamsbaum
No abstract text is available yet for this article.
March 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28302360/consistent-screening-of-admitted-infants-with-head-injuries-reveals-high-rate-of-nonaccidental-trauma
#10
Paul T Kim, Jillian McCagg, Ashley Dundon, Zach Ziesler, Suzanne Moody, Richard A Falcone
PURPOSE: Implementation of a nonaccidental trauma (NAT) screening guideline for the evaluation of infants admitted with an unwitnessed head injury has eliminated screening disparities. This study sought to determine the overall NAT rate and key predictive factors using this guideline. METHODS: All infants screened via the guideline from 2008 to 2015 were retrospectively reviewed. The overall rate of NAT as determined by our child abuse team was determined. In addition, a logistic regression model was developed to evaluate potential predictors of increased risk of NAT...
March 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28245144/cns-injuries-in-abusive-head-trauma
#11
Jason N Wright
OBJECTIVE: Abusive head trauma (AHT) is one of the most common subtypes of nonaccidental trauma and is a leading cause of traumatic brain injury in young children. Imaging plays a crucial role in the evaluation of children with suspected AHT and can aid in accurate diagnosis because clinical presentation may be nonspecific. In this article, the CNS injuries that are characteristic of AHT are reviewed with an emphasis on pathophysiology and imaging appearance. CONCLUSION: AHT is a frequent cause of neurologic injury in children, particularly in infants in the first year of life...
February 28, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28242132/abducens-nerve-palsy-due-to-inferior-petrosal-sinus-thrombosis
#12
Shivam Om Mittal, Junaid Siddiqui, Bashar Katirji
Isolated unilateral abducens nerve palsy is usually due to ischemia, trauma or neoplasm. Dorello's canal is the space between the petrous apex and superolateral portion of the clivus, bound superiorly by Gruber's ligament. The abducens nerve travels with inferior petrosal sinus (IPS) though the Dorello's canal before entering the cavernous sinus. A 31-year-old man presented with neck pain, and binocular horizontal diplopia, worse looking towards left and at distance. He had a history of intravenous drug abuse but no history of hypertension or diabetes...
February 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28211592/a-methodology-for-assessing-deployment-trauma-and-its-consequences-in-oef-oif-ond-veterans-the-tracts-longitudinal-prospective-cohort-study
#13
Regina E McGlinchey, William P Milberg, Jennifer R Fonda, Catherine Brawn Fortier
Many US veterans of Afghanistan and Iraq have multiple physical and psychiatric problems. A major focus of research has been on determining the effects of mild Traumatic Brain Injury (mTBI), but mTBI is rarely diagnosed in the absence of co-occurring conditions such as blast exposure, post-traumatic stress disorder (PTSD), depression, substance abuse, etc. These potentially interactive psychological and physical conditions produce complex patterns of cognitive, psychological, and physical symptoms that impede civilian reintegration and complicate efficient and effective treatment planning...
February 17, 2017: International Journal of Methods in Psychiatric Research
https://www.readbyqxmd.com/read/28190553/cervical-spine-imaging-for-young-children-with-inflicted-trauma-expanding-the-injury-pattern
#14
Joanne Baerg, Arul Thirumoorthi, Rosemary Vannix, Asma Taha, Amy Young, Alexander Zouros
AIM: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma. METHODS: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28183837/diagnostic-performance-of-ultrafast-brain-mri-for-evaluation-of-abusive-head-trauma
#15
S F Kralik, M Yasrebi, N Supakul, C Lin, L G Netter, R A Hicks, R A Hibbard, L L Ackerman, M L Harris, C Y Ho
BACKGROUND AND PURPOSE: MR imaging with sedation is commonly used to detect intracranial traumatic pathology in the pediatric population. Our purpose was to compare nonsedated ultrafast MR imaging, noncontrast head CT, and standard MR imaging for the detection of intracranial trauma in patients with potential abusive head trauma. MATERIALS AND METHODS: A prospective study was performed in 24 pediatric patients who were evaluated for potential abusive head trauma...
February 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28160241/retinal-haemorrhages-in-a-university-hospital-not-always-abusive-head-injury
#16
M Mattheij, C Venstermans, I de Veuster, I Vanderstraete, T Menovsky, P Jorens, B Ceulemans
Retinal haemorrhages (RH) and subdural haematomas (SDH) are frequently seen in abusive head trauma (AHT). The aim of our study is to show that they are suggestive, but not pathognomonic for AHT. We performed an observational retrospective study on children, aged 1-18 months old, admitted to the Antwerp University Hospital with RH. History, physical examination, medical course, coagulation and metabolic tests, skeletal survey, head circumference, retinal findings, cerebral imaging, and evaluation reports by social services or civil/criminal courts were collected...
February 3, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28135369/prevention-of-pediatric-abusive-head-trauma-time-to-rethink-interventions-and-reframe-messages
#17
John M Leventhal, Andrea G Asnes, Kirsten Bechtel
No abstract text is available yet for this article.
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28135348/association-of-a-postnatal-parent-education-program-for-abusive-head-trauma-with-subsequent-pediatric-abusive-head-trauma-hospitalization-rates
#18
Mark S Dias, Carroll M Rottmund, Kelly M Cappos, Marie E Reed, Ming Wang, Christina Stetter, Michele L Shaffer, Christopher S Hollenbeak, Ian M Paul, Cindy W Christian, Rachel P Berger, Joanne Klevens
Importance: Studies suggest that a postnatal parental intervention may reduce the incidence of abusive head trauma (AHT) of infants and young children. Objective: To assess the effect of statewide universal AHT education for parents on AHT hospitalization rates in Pennsylvania and on parents' self-reported knowledge gains and parenting behaviors. Design, Setting, and Participants: Changes in AHT hospitalization rates in Pennsylvania before and during the intervention were compared with those in 5 other states lacking universal parental AHT education during the same period...
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28104500/photographic-assessment-of-retinal-hemorrhages-in-infant-head-injury-the-childhood-hemorrhagic-retinopathy-study
#19
Gaurav Bhardwaj, Mark B Jacobs, Frank J Martin, Kieran T Moran, Kristina Prelog, Craig Donaldson, Ute Vollmer-Conna, Minas T Coroneo
BACKGROUND: Retinal hemorrhages (RH) in babies in the absence of severe trauma or a medical cause have been strongly associated with abusive head trauma (AHT). We examined the pattern of RH in accidental head injury and AHT objectively using widefield retinal imaging. METHODS: A total of 118 infants and children 1-36 months of age admitted with head injuries at two centers were included in this prospective, consecutive, comparative cohort study. Dilated fundus examination was performed with indirect ophthalmoscopy and widefield imaging...
February 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28087346/patterns-of-retinal-hemorrhage-associated-with-pediatric-cerebral-sinovenous-thrombosis
#20
Gil Binenbaum, Julia E Reid, David L Rogers, Anne K Jensen, Lori L Billinghurst, Brian J Forbes
BACKGROUND: Cerebral sinovenous thrombosis (CSVT) has been proposed as an alternative cause of retinal hemorrhage (RH) in children being evaluated for abusive head trauma. This study investigated the prevalence and characteristics of RH in children with CSVT. METHODS: The medical records of children >6 weeks of age with newly diagnosed CSVT and fundus examination by an ophthalmologist were examined retrospectively. Primary outcomes were presence and patterns of RH...
February 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
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