Abusive Head Trauma Case Study
Abusive head trauma (AHT) is the most common finding of NAI leading to death in children under 1 year old (22). Even a low suspicion of AHT should require appropriate follow-up imaging given the morbidity and mortality traumatic intracranial injury (22). Injuries includes collision with a stationary object, direct impact to the head, and alternating acceleration and deceleration (22). Infants are particularly at risk for traumatic brain injury as a result of being shaken due to the relative weight of the head compared to the rest of the body, and relative lack of strength of the neck musculature (22). Additional physical examination findings such as retinal haemorrhage may raise suspicion of NAI, but discordance of injury patterns with
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Physicians must consider conditions related to collagen production, bone mineralisation and other pathologies resulting in bone fragility (21, 23). There are also many conditions which may mimic NAI, such as skeletal dysplasias, osteomyelitis and sickle cell disease (21). The rare disorder of congenital indifference to pain, asymbolia, has similar radiological appearances to NAI (32). Menkes syndrome, a rare metabolic condition involving copper storage, is identified using genetic studies and hair analysis, and can produce overlapping findings with NAI …show more content…
Radiological reporting must state the adequacy of imaging, describe anomalies, rule out any differential diagnoses, and communicate the suspicion of NAI (26). The degree of certainty of NAI must also be accurately communicated to physicians and thus to child protective services (26).
Laws governing the health and welfare of children vary between countries (32). In Australia, all physicians are legally mandated to report cases of suspected NAI (19). If NAI is suspected, child protective services is notified and civil court proceeding begin (1). This can take several months before judgement is formed, due to pending reports, court hearings and evaluations (33). While the child is moved to a position of safety, child protective services, the police and the court will act in the child’s best interest
Physicians must consider conditions related to collagen production, bone mineralisation and other pathologies resulting in bone fragility (21, 23). There are also many conditions which may mimic NAI, such as skeletal dysplasias, osteomyelitis and sickle cell disease (21). The rare disorder of congenital indifference to pain, asymbolia, has similar radiological appearances to NAI (32). Menkes syndrome, a rare metabolic condition involving copper storage, is identified using genetic studies and hair analysis, and can produce overlapping findings with NAI …show more content…
Radiological reporting must state the adequacy of imaging, describe anomalies, rule out any differential diagnoses, and communicate the suspicion of NAI (26). The degree of certainty of NAI must also be accurately communicated to physicians and thus to child protective services (26).
Laws governing the health and welfare of children vary between countries (32). In Australia, all physicians are legally mandated to report cases of suspected NAI (19). If NAI is suspected, child protective services is notified and civil court proceeding begin (1). This can take several months before judgement is formed, due to pending reports, court hearings and evaluations (33). While the child is moved to a position of safety, child protective services, the police and the court will act in the child’s best interest