This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Morris, M. W.
Right arrow Articles by Ancheta, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Morris, M. W.
Right arrow Articles by Ancheta, J.
Related Collections
Right arrow Office Practice

PEDIATRICS Vol. 105 No. 3 March 2000, pp. 549-553

Evaluation of Infants With Subdural Hematoma Who Lack External Evidence of Abuse

Received Sep 28, 1998; accepted Jun 2, 1999.

Mark W. Morris*, §, Sally Smith*, Dagger , §, Joanne Cressman*, and Joey AnchetaDagger

From the * Departments of Pediatric Medicine and Pediatric Radiology, All Children's Hospital, St Petersburg, Florida; Dagger  Department of Pediatrics, University of South Florida, School of Medicine, Tampa, Florida; and § Suncoast Child Protection Team, Pinellas County, Florida.

Objective.  Advances in radiologic technique have increased the recognition of subdural hematoma. No study to date has addressed the role of child protective investigation into the cause and management of subdural hematoma in children who lack other indicators of abuse.

Methods.  Medical records, radiology studies, and social service notes for all infants and children referred for child abuse investigation who had any form of intracranial hemorrhage were reviewed. The study covered the 12 months of 1997. All referrals were to the Suncoast Child Protection Team (St Petersburg, FL).

Results.  There were 19 investigations because of subdural hematoma. Eight children had retinal hemorrhage as well as other major findings of trauma, such as bruises and/or fractures; all 8 were victims of child abuse. Two infants had tiny subdurals adjacent to accidental linear skull fractures. Nine infants were investigated for the possibility of abuse that had no findings of trauma apart from the subdural hematoma. These 9 cases form the basis for this study. The age range was 11 days to 15 months. Inflicted cerebral trauma was the medical diagnosis in 8 of the 9 cases; 1 case had a final diagnosis of possible inflicted injury in a high-risk setting.

Conclusions.  Infants with subdural hematoma but no other findings of abuse present a difficult challenge to child protection workers. Investigation by a medically oriented team can uncover the circumstances of the trauma in most instances and can usefully direct protective efforts. The high incidence of severe sequelae in infants with inflicted cerebral trauma warrants a vigorous approach.  Key words:  subdural hematoma, intracranial hemorrhage, traumatic brain injury, child abuse, child protection.




This article has been cited by other articles:


Home page
 CLIN PEDIATRHome page
K. Vellody, J. P. Freeto, S. L. Gage, N. Collins, and W. M. Gershan
Clues That Aid in the Diagnosis of Nonaccidental Trauma Presenting as an Apparent Life-Threatening Event
Clinical Pediatrics, November 1, 2008; 47(9): 912 - 918.
[Abstract] [PDF]

Home page
 PediatricsHome page
R. P. Berger, T. Dulani, P. D. Adelson, J. M. Leventhal, R. Richichi, and P. M. Kochanek
Identification of Inflicted Traumatic Brain Injury in Well-Appearing Infants Using Serum and Cerebrospinal Markers: A Possible Screening Tool
Pediatrics, February 1, 2006; 117(2): 325 - 332.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
S Datta, N Stoodley, S Jayawant, S Renowden, and A Kemp
Neuroradiological aspects of subdural haemorrhages
Arch. Dis. Child., September 1, 2005; 90(9): 947 - 951.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. A. Brand, R. L. Altman, K. Purtill, and K. S. Edwards
Yield of Diagnostic Testing in Infants Who Have Had an Apparent Life-Threatening Event
Pediatrics, April 1, 2005; 115(4): 885 - 893.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
R. L. Altman, D. A. Brand, S. Forman, M. L. Kutscher, D. B. Lowenthal, K. A. Franke, and V. V. Mercado
Abusive Head Injury as a Cause of Apparent Life-Threatening Events in Infancy
Arch Pediatr Adolesc Med, October 1, 2003; 157(10): 1011 - 1015.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
I Blumenthal
Shaken baby syndrome
Postgrad. Med. J., December 1, 2002; 78(926): 732 - 735.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. W. Feldman, R. Bethel, R. P. Shugerman, D. C. Grossman, M. S. Grady, and R. G. Ellenbogen
The Cause of Infant and Toddler Subdural Hemorrhage: A Prospective Study
Pediatrics, September 1, 2001; 108(3): 636 - 646.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
O. Bodamer;, M. W. Morris, and S. Smith
Aseptic meningitis.
Pediatrics, February 1, 2001; 107(2): 451 - 451.
[Full Text]