Abusive Head Trauma

Abstract

Abusive head trauma (AHT) (e.g. shaken baby syndrome) is the leading cause of death from child abuse. Proper diagnosis of AHT is critical; if AHT is not identifi ed, children can be inadvertently returned to a violent environment where they can be re-injured or killed. The intensivist plays a critical role in the identifi cation, evaluation, and treatment of AHT. This chapter will focus on the clinical presentation of AHT, the medical evaluation for cranial and non-cranial injuries in cases of suspected AHT as well as the management and treatment of AHT with a focus on the differences between management of children with AHT vs. non-abusive TBI. Current data related to the mechanism of injury and pathophysiology of AHT will also be discussed. Finally, issues related to mandated reporting and legal proceedings related to AHT cases will be discussed as will the role of the intensivist in all of the above.

The Anesthesiologist’s Role in Treating Abusive Head Trauma

“…As long as the report is made in good faith, physicians are protected by law from potential ramifications of the report. 108 …”

“…Reporting suspected abuse could save a child’s life and protect other children in the same home and social environment. 108 …”