Pediatric abusive head trauma, often known as shaken baby syndrome, is characterized by shaking, blunt impact, in newborns and young children, and can result in cerebral damage. This illness can result in full recovery, substantial brain damage, or death.
Head trauma is the most prevalent cause of traumatic mortality in children under the age of two. These individuals should be handled with the objective of keeping blood pressure and intracranial pressure low while maintaining appropriate cerebral perfusion pressure.
Epidemiology
The condition is challenging to identify. As a result, the incidence is unknown. It is due to a lack of a centralized reporting system, the absence of symptoms of maltreatment, confusing presentation, and acute head trauma not being a single isolated occurrence but rather part of chronic neglect and abuse that culminates in significant morbidity and mortality.
The incidence in the first year of life is estimated to be 35 incidents per 100,000 newborns. Injury of the head causes severe morbidity and mortality. Approximately 65% have serious neurological abnormalities, and 5 to 35% of newborns die from injuries. Most survivors suffer from both neurologic and cognitive disabilities.
According to the CDC, abusive head trauma accounts for around 10% of the 2000 children who die from maltreatment each year. The average age of a victim of shaken infant syndrome is three to eight months. It has also been documented in infants and children up to four.
Anatomy
Pathophysiology
The most common cause of abusive pediatric head trauma is rage and irritation over a newborn’s excessive screaming and continuous cry. An incidence of head trauma alters the lives of caregivers and their families for the rest of their life. One of the most severe types of child maltreatment is abusive head trauma.
It is the leading cause of death in children under two. Most fatal injuries caused by child maltreatment result from abusive head trauma. Shaking injuries caused by repetitive fast extension, flexion, and head and neck rotation is the underlying mechanism of abusive head trauma. The fast movement of the brain against the skull might rupture veins, resulting in bleeding and a hematoma.
A growing hematoma may put pressure on the brain, causing more injury. Diffuse axonal damage occurs when shear pressures throughout the brain destroy nerve axons. Infant skulls are wide and heavy, and the neck muscles are insufficient to support a massive head.
More significant movement is achieved by rapid and repeated flexion, extension, and rotation. Additional injuries such as bruising, fractures, and lacerations are noticed when the head collides with an object. Even contact with delicate items might cause serious injuries.
Etiology
Colic is a warning flag. Infant crying peaks between 6 and 8 weeks of age and subsequently diminishes. As a result, abusive head trauma is at its greatest. Shaking is frequently related to the perpetrator’s rage and tension. Child abuse affects people of all socioeconomic backgrounds and races, with males and teenagers most vulnerable.
Physical abuse causes higher morbidity and death in infants. Maternal smoking and parental instability are particular hazards. Domestic violence in the home and having more than two children in the house are both risks at the familial level.
Isolation, a lack of recreational amenities, and socioeconomic issues such as poverty are all risks at the community level. Parental education in infant health and parenting, social support, and parental resilience are the preventive factors.
Genetics
Prognostic Factors
Abuse of the head is related to significant mortality and morbidity. The severity of morbidity ranges from moderate learning difficulties to severe physical or cognitive abnormalities and death.
Blindness, developmental delays, attention deficiency, intellectual deficits, sensory deficits, motor dysfunction, hearing impairment, eating difficulty, failure to thrive, seizures, and educational and behavioral challenges are all possible outcomes.
Head abuse can result in quadriplegia, hemiplegia, microcephaly, and hydrocephaly. The level of impairment observed on MRI and CT imaging corresponds with the prognosis of individuals with abusive head trauma.
Children who have suffered abusive head trauma are more likely to die than children who have had accidental head damage. Additionally, half of the children aged 0 to 4 years who are harmed by abusive head trauma die before age 21. Children with significant head trauma have a 55% drop in health-related quality of life.
Clinical History
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References
https://www.ncbi.nlm.nih.gov/books/NBK499836/
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Pediatric abusive head trauma, often known as shaken baby syndrome, is characterized by shaking, blunt impact, in newborns and young children, and can result in cerebral damage. This illness can result in full recovery, substantial brain damage, or death.
Head trauma is the most prevalent cause of traumatic mortality in children under the age of two. These individuals should be handled with the objective of keeping blood pressure and intracranial pressure low while maintaining appropriate cerebral perfusion pressure.
The condition is challenging to identify. As a result, the incidence is unknown. It is due to a lack of a centralized reporting system, the absence of symptoms of maltreatment, confusing presentation, and acute head trauma not being a single isolated occurrence but rather part of chronic neglect and abuse that culminates in significant morbidity and mortality.
The incidence in the first year of life is estimated to be 35 incidents per 100,000 newborns. Injury of the head causes severe morbidity and mortality. Approximately 65% have serious neurological abnormalities, and 5 to 35% of newborns die from injuries. Most survivors suffer from both neurologic and cognitive disabilities.
According to the CDC, abusive head trauma accounts for around 10% of the 2000 children who die from maltreatment each year. The average age of a victim of shaken infant syndrome is three to eight months. It has also been documented in infants and children up to four.
The most common cause of abusive pediatric head trauma is rage and irritation over a newborn’s excessive screaming and continuous cry. An incidence of head trauma alters the lives of caregivers and their families for the rest of their life. One of the most severe types of child maltreatment is abusive head trauma.
It is the leading cause of death in children under two. Most fatal injuries caused by child maltreatment result from abusive head trauma. Shaking injuries caused by repetitive fast extension, flexion, and head and neck rotation is the underlying mechanism of abusive head trauma. The fast movement of the brain against the skull might rupture veins, resulting in bleeding and a hematoma.
A growing hematoma may put pressure on the brain, causing more injury. Diffuse axonal damage occurs when shear pressures throughout the brain destroy nerve axons. Infant skulls are wide and heavy, and the neck muscles are insufficient to support a massive head.
More significant movement is achieved by rapid and repeated flexion, extension, and rotation. Additional injuries such as bruising, fractures, and lacerations are noticed when the head collides with an object. Even contact with delicate items might cause serious injuries.
Colic is a warning flag. Infant crying peaks between 6 and 8 weeks of age and subsequently diminishes. As a result, abusive head trauma is at its greatest. Shaking is frequently related to the perpetrator’s rage and tension. Child abuse affects people of all socioeconomic backgrounds and races, with males and teenagers most vulnerable.
Physical abuse causes higher morbidity and death in infants. Maternal smoking and parental instability are particular hazards. Domestic violence in the home and having more than two children in the house are both risks at the familial level.
Isolation, a lack of recreational amenities, and socioeconomic issues such as poverty are all risks at the community level. Parental education in infant health and parenting, social support, and parental resilience are the preventive factors.
Abuse of the head is related to significant mortality and morbidity. The severity of morbidity ranges from moderate learning difficulties to severe physical or cognitive abnormalities and death.
Blindness, developmental delays, attention deficiency, intellectual deficits, sensory deficits, motor dysfunction, hearing impairment, eating difficulty, failure to thrive, seizures, and educational and behavioral challenges are all possible outcomes.
Head abuse can result in quadriplegia, hemiplegia, microcephaly, and hydrocephaly. The level of impairment observed on MRI and CT imaging corresponds with the prognosis of individuals with abusive head trauma.
Children who have suffered abusive head trauma are more likely to die than children who have had accidental head damage. Additionally, half of the children aged 0 to 4 years who are harmed by abusive head trauma die before age 21. Children with significant head trauma have a 55% drop in health-related quality of life.
https://www.ncbi.nlm.nih.gov/books/NBK499836/
medtigo
Neonatal Injuries in Child Abuse
Updated :
October 4, 2022
Pediatric abusive head trauma, often known as shaken baby syndrome, is characterized by shaking, blunt impact, in newborns and young children, and can result in cerebral damage. This illness can result in full recovery, substantial brain damage, or death.
Head trauma is the most prevalent cause of traumatic mortality in children under the age of two. These individuals should be handled with the objective of keeping blood pressure and intracranial pressure low while maintaining appropriate cerebral perfusion pressure.
The condition is challenging to identify. As a result, the incidence is unknown. It is due to a lack of a centralized reporting system, the absence of symptoms of maltreatment, confusing presentation, and acute head trauma not being a single isolated occurrence but rather part of chronic neglect and abuse that culminates in significant morbidity and mortality.
The incidence in the first year of life is estimated to be 35 incidents per 100,000 newborns. Injury of the head causes severe morbidity and mortality. Approximately 65% have serious neurological abnormalities, and 5 to 35% of newborns die from injuries. Most survivors suffer from both neurologic and cognitive disabilities.
According to the CDC, abusive head trauma accounts for around 10% of the 2000 children who die from maltreatment each year. The average age of a victim of shaken infant syndrome is three to eight months. It has also been documented in infants and children up to four.
The most common cause of abusive pediatric head trauma is rage and irritation over a newborn’s excessive screaming and continuous cry. An incidence of head trauma alters the lives of caregivers and their families for the rest of their life. One of the most severe types of child maltreatment is abusive head trauma.
It is the leading cause of death in children under two. Most fatal injuries caused by child maltreatment result from abusive head trauma. Shaking injuries caused by repetitive fast extension, flexion, and head and neck rotation is the underlying mechanism of abusive head trauma. The fast movement of the brain against the skull might rupture veins, resulting in bleeding and a hematoma.
A growing hematoma may put pressure on the brain, causing more injury. Diffuse axonal damage occurs when shear pressures throughout the brain destroy nerve axons. Infant skulls are wide and heavy, and the neck muscles are insufficient to support a massive head.
More significant movement is achieved by rapid and repeated flexion, extension, and rotation. Additional injuries such as bruising, fractures, and lacerations are noticed when the head collides with an object. Even contact with delicate items might cause serious injuries.
Colic is a warning flag. Infant crying peaks between 6 and 8 weeks of age and subsequently diminishes. As a result, abusive head trauma is at its greatest. Shaking is frequently related to the perpetrator’s rage and tension. Child abuse affects people of all socioeconomic backgrounds and races, with males and teenagers most vulnerable.
Physical abuse causes higher morbidity and death in infants. Maternal smoking and parental instability are particular hazards. Domestic violence in the home and having more than two children in the house are both risks at the familial level.
Isolation, a lack of recreational amenities, and socioeconomic issues such as poverty are all risks at the community level. Parental education in infant health and parenting, social support, and parental resilience are the preventive factors.
Abuse of the head is related to significant mortality and morbidity. The severity of morbidity ranges from moderate learning difficulties to severe physical or cognitive abnormalities and death.
Blindness, developmental delays, attention deficiency, intellectual deficits, sensory deficits, motor dysfunction, hearing impairment, eating difficulty, failure to thrive, seizures, and educational and behavioral challenges are all possible outcomes.
Head abuse can result in quadriplegia, hemiplegia, microcephaly, and hydrocephaly. The level of impairment observed on MRI and CT imaging corresponds with the prognosis of individuals with abusive head trauma.
Children who have suffered abusive head trauma are more likely to die than children who have had accidental head damage. Additionally, half of the children aged 0 to 4 years who are harmed by abusive head trauma die before age 21. Children with significant head trauma have a 55% drop in health-related quality of life.
https://www.ncbi.nlm.nih.gov/books/NBK499836/
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