@article{ref1,
title="Head injury pattern in children can help differentiate accidental from non-accidental trauma",
journal="Pediatric surgery international",
year="2014",
author="Roach, Jonathan P. and Acker, Shannon N. and Bensard, Denis D. and Sirotnak, Andrew P. and Karrer, Frederick M. and Partrick, David A.",
volume="30",
number="11",
pages="1103-1106",
abstract="OBJECTIVES: Our aim was to define the radiographic findings that help differentiate abusive head trauma (AHT) from accidental head injury. <br><br>METHODS: Our trauma registry was queried for all children ≤5 years of age presenting with traumatic brain injury (TBI) from 1996-2011. <br><br>RESULTS: Of 2,015 children with TBI, 71 % had accidental injury and 29 % had AHT. Children with AHT were more severely injured (ISS 22.1 vs 14.4; p < 0.0001) and had a higher mortality rate (15 vs 5 %; p < 0.0001). Patients with AHT had higher rates of diffuse axonal injury (14 vs 8 %; p < 0.0001) and subdural hemorrhage (76 vs 23 %; p < 0.0001). Children with accidental injury had higher rates of skull fractures (52 vs 21 %; p < 0.0001) and epidural hemorrhages (11 vs 3 %). <br><br>CONCLUSIONS: AHT occurred in 29 % of children and resulted in increased mortality rates. These children had higher rates of subdural hemorrhages and diffuse axonal injury. Physicians initially evaluating injured children must maintain a high index of suspicion for abuse in those who present with subdural hematoma or diffuse axonal injury.<p /> <p>Language: en</p>",
language="en",
issn="0179-0358",
doi="10.1007/s00383-014-3598-3",
url="http://dx.doi.org/10.1007/s00383-014-3598-3"
}