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Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis

The term “shaken baby syndrome” has been replaced by “abusive head trauma (AHT)” based on the mechanism of injury. The reported mortality rate of AHT ranges from 10% to 30%. Up to two-thirds of survivors suffer from serious long-term disabilities. Thus, an expeditious and accurate diagnosis is cruci...

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Autores principales: Yoon, Seokwon, Lee, Juyoung, Jun, Yong Hoon, Jeon, Ga Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221573/
https://www.ncbi.nlm.nih.gov/pubmed/35740745
http://dx.doi.org/10.3390/children9060808
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author Yoon, Seokwon
Lee, Juyoung
Jun, Yong Hoon
Jeon, Ga Won
author_facet Yoon, Seokwon
Lee, Juyoung
Jun, Yong Hoon
Jeon, Ga Won
author_sort Yoon, Seokwon
collection PubMed
description The term “shaken baby syndrome” has been replaced by “abusive head trauma (AHT)” based on the mechanism of injury. The reported mortality rate of AHT ranges from 10% to 30%. Up to two-thirds of survivors suffer from serious long-term disabilities. Thus, an expeditious and accurate diagnosis is crucial to prevent further abuse that might result in death or serious disabilities. It remains a challenge for physicians to diagnose AHT when parents do not give a history of trauma in preverbal infants without any external signs. Here, we report a case of a 14-day-old boy who presented with a febrile convulsion without evident external injuries nor history of trauma according to his parents. He was diagnosed with AHT based on MRI findings of subacute subdural hemorrhage, multiple cortical hemorrhages, cerebral edema, and diffuse axonal injury. In conclusion, health care providers should keep in mind that the history of trauma provided by the parents or caregivers might not always be true and that reasonable suspicion of abuse is the most important in the diagnosis of AHT, although neuroimaging plays a pivotal role. Reasonable suspicion of AHT in combination with a thorough physical examination, neuroimaging, and skilled neuroradiologist can improve diagnosis and help victims in a timely manner.
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spelling pubmed-92215732022-06-24 Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis Yoon, Seokwon Lee, Juyoung Jun, Yong Hoon Jeon, Ga Won Children (Basel) Case Report The term “shaken baby syndrome” has been replaced by “abusive head trauma (AHT)” based on the mechanism of injury. The reported mortality rate of AHT ranges from 10% to 30%. Up to two-thirds of survivors suffer from serious long-term disabilities. Thus, an expeditious and accurate diagnosis is crucial to prevent further abuse that might result in death or serious disabilities. It remains a challenge for physicians to diagnose AHT when parents do not give a history of trauma in preverbal infants without any external signs. Here, we report a case of a 14-day-old boy who presented with a febrile convulsion without evident external injuries nor history of trauma according to his parents. He was diagnosed with AHT based on MRI findings of subacute subdural hemorrhage, multiple cortical hemorrhages, cerebral edema, and diffuse axonal injury. In conclusion, health care providers should keep in mind that the history of trauma provided by the parents or caregivers might not always be true and that reasonable suspicion of abuse is the most important in the diagnosis of AHT, although neuroimaging plays a pivotal role. Reasonable suspicion of AHT in combination with a thorough physical examination, neuroimaging, and skilled neuroradiologist can improve diagnosis and help victims in a timely manner. MDPI 2022-05-30 /pmc/articles/PMC9221573/ /pubmed/35740745 http://dx.doi.org/10.3390/children9060808 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Yoon, Seokwon
Lee, Juyoung
Jun, Yong Hoon
Jeon, Ga Won
Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis
title Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis
title_full Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis
title_fullStr Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis
title_full_unstemmed Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis
title_short Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis
title_sort neonatal abusive head trauma without external injuries: suspicion improves diagnosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221573/
https://www.ncbi.nlm.nih.gov/pubmed/35740745
http://dx.doi.org/10.3390/children9060808
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