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| | #REDIRECT[[Nonaccidental trauma]] |
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| NONACCIDENTAL TRAUMA
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| - abusive head trauma most common cause of traumatic death in infants
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| - risk factors for abuse
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| * infant
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| * lower status
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| * family problems
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| * disability or prematurity of infant
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| - historical alternans, or may present with medical complaints like irreg breathing, apnea, sz, irritable, lethargic, vomiting, poor feeding
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| - retinal hem usually from abuse may rarely be from other trauma
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| - most common abusive lesions are
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| * subarach hem
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| * subdural
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| * interhemispheric blood
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| * cerebral edema
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| * same lesion not common with accidental trauma but possible
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| - fx assoc with abuse are multiple, bilateral, cross sutures, diastatic, nonparietal, assoc with subdural
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| - skull fx from short fall <3 ft usually linear
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| Recommendations
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| - ct if ams
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| - consider ct if h/o loc, amnesia, sz, HA, vomiting, irritable, behavioral change
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| - if mild sxs, no ct but observe at home
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| - lower threshold if young <1-2 yrs since skull fx more common and more risk for abuse
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| - image if significant scalp findings
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| - consider abuse if no hx of trauma, delay in seeking care, changing story, repeated injuries, mismatch of hx with physical exam, wounds of diff stages of healing
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| - call neurosurg if intracranial inj, skull fx depressed or widely diastatic
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| ==See also==
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| Peds: Head CT (Peds)
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| ==Source==
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| Adapted from Pani
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| [[Category:Peds]] | |
