Pediatric Abusive Head Trauma

Pediatric abusive head trauma – once commonly known as the shaken baby syndrome – is a form of child abuse that results in traumatic brain injury. The peak incidence of pediatric abusive head trauma appears to be in children between the ages of 2 to 4 months; the exact incidence of this injury is not known. Pediatric abusive head trauma often results in severe and permanent neurological damage, and the associated mortality rate is very high. It is often characterized by a diagnostic triad of encephalopathy, subdural hemorrhage, and retinal hemorrhage and other serious injuries may be seen, as well. The traditional explanation for pediatric abusive head trauma is that it is caused by violent shaking that results in shearing and breaking of blood vessels in the brain. However, shaking alone likely does not – and cannot – account for the damage seen in cases of pediatric abusive head trauma, the exact mechanism of injury is not known, and the term shaken baby syndrome is no longer accepted by the medical community. Detection of pediatric abusive head trauma can be very difficult, but detection rates can probably be improved with education and vigilant screening. This course provides an overview of the recognition and prevention of pediatric abusive head trauma. Specific topics include etiology and risk factors, the clinical characteristics, detection and diagnosis, working with the family or caregivers and the prevention of pediatric abusive head trauma.