Characteristics That Distinguish Abusive From Nonabusive Head Trauma Among Young Children Who Underwent Head Computed Tomography in Japan. Export

@article{citeulike:3207304, abstract = {OBJECTIVE. Distinguishing abusive head trauma in young children from other diseases by symptoms is difficult in practice. Comparisons between abusive and nonabusive head trauma in young children in Japan, where computed tomography is widely and easily available, might contribute to identifying markers of abusive head trauma that differ from that in Western countries. The objective of this study was to compare the characteristics of abusive and nonabusive head trauma in young children in Japan. METHODS. A comparative case series study involving a retrospective medical chart and social work record review of children who were aged 0 to 2 years, visited the National Center for Child Health and Development (Tokyo, Japan) from March 1, 2002, to December 31, 2005, and underwent computed tomography scanning because of suspected intracranial injury was performed. Patients (N = 260) were identified and classified as having either abusive or nonabusive head trauma on the basis of the published definition. Demographic and perinatal characteristics, injury history, clinical presentation, and outcomes were compared by using chi(2) and Fisher's exact tests. RESULTS. Patients with abusive head trauma were significantly younger than patients with nonabusive head trauma and had a peak at approximately 2 to 4 and 7 to 9 months. Patients with abusive head trauma more likely presented no injury history by the caregiver, neurologic symptoms (unconsciousness, seizure, paralysis), subdural hemorrhage, and retinal hemorrhages. Although patients with abusive head trauma had severe clinical outcomes, only 32\% of them were separated from the caregiver by social welfare services. CONCLUSIONS. This study highlights the several clinical markers to detect abusive head trauma at a medical visit, including an absence of injury history, neurologic symptoms, subdural hemorrhage, and retinal hemorrhage. These markers can be used to detect abusive head trauma cases by physicians and social welfare workers to protect children from additional abuse.}, address = {aSection of Behavioral Science, Department of Health Promotion and Research, National Institute of Public Health, Saitama, Japan.}, author = {Fujiwara, Takeo and Okuyama, Makiko and Miyasaka, Mikiko}, citeulike-article-id = {3207304}, citeulike-linkout-0 = {http://dx.doi.org/10.1542/peds.2008-0387}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18762487}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18762487}, day = {1}, doi = {10.1542/peds.2008-0387}, issn = {1098-4275}, journal = {Pediatrics}, keywords = {abuse}, month = {September}, posted-at = {2008-09-09 03:31:57}, priority = {2}, title = {Characteristics That Distinguish Abusive From Nonabusive Head Trauma Among Young Children Who Underwent Head Computed Tomography in Japan.}, url = {http://dx.doi.org/10.1542/peds.2008-0387}, year = {2008} }

TY - JOUR ID - citeulike:3207304 L3 - citeulike-article-id:3207304 N2 - OBJECTIVE. Distinguishing abusive head trauma in young children from other diseases by symptoms is difficult in practice. Comparisons between abusive and nonabusive head trauma in young children in Japan, where computed tomography is widely and easily available, might contribute to identifying markers of abusive head trauma that differ from that in Western countries. The objective of this study was to compare the characteristics of abusive and nonabusive head trauma in young children in Japan. METHODS. A comparative case series study involving a retrospective medical chart and social work record review of children who were aged 0 to 2 years, visited the National Center for Child Health and Development (Tokyo, Japan) from March 1, 2002, to December 31, 2005, and underwent computed tomography scanning because of suspected intracranial injury was performed. Patients (N = 260) were identified and classified as having either abusive or nonabusive head trauma on the basis of the published definition. Demographic and perinatal characteristics, injury history, clinical presentation, and outcomes were compared by using chi(2) and Fisher's exact tests. RESULTS. Patients with abusive head trauma were significantly younger than patients with nonabusive head trauma and had a peak at approximately 2 to 4 and 7 to 9 months. Patients with abusive head trauma more likely presented no injury history by the caregiver, neurologic symptoms (unconsciousness, seizure, paralysis), subdural hemorrhage, and retinal hemorrhages. Although patients with abusive head trauma had severe clinical outcomes, only 32% of them were separated from the caregiver by social welfare services. CONCLUSIONS. This study highlights the several clinical markers to detect abusive head trauma at a medical visit, including an absence of injury history, neurologic symptoms, subdural hemorrhage, and retinal hemorrhage. These markers can be used to detect abusive head trauma cases by physicians and social welfare workers to protect children from additional abuse. JF - Pediatrics SN - 1098-4275 AD - aSection of Behavioral Science, Department of Health Promotion and Research, National Institute of Public Health, Saitama, Japan. TI - Characteristics That Distinguish Abusive From Nonabusive Head Trauma Among Young Children Who Underwent Head Computed Tomography in Japan. KW - abuse AU - Fujiwara, Takeo AU - Okuyama, Makiko AU - Miyasaka, Mikiko PY - 2008/09/01/ UR - http://dx.doi.org/10.1542/peds.2008-0387 ER -