Abusive Head Trauma
- Evaluate for potential diseases of bleeding, abdominal trauma (enzymes) and bone diseases (bone labs);
- Do a skeletal survey following current guidelines for all children with potential AHT, particularly those younger than 2 years;
- For an acutely ill child with neurologic impairment, an optimal imaging strategy involves initial unenhanced CT with 3-D reformatted images of the calvarium, followed by a full multi-sequence MRI of the brain and the cervical, thoracic and lumbar spine as soon as feasible;
- Suspicion of AHT warrants comprehensive imaging, and the decision rule developed from a network of emergency departments regarding the use of imaging in low-risk blunt head trauma (PECARN) does not apply for AHT.
Accessible Version
After the physical examination and history gathering, it is important to consider evaluating for potential diseases of bleeding, abdominal trauma (enzymes) and bone diseases (bone labs); Do a skeletal survey following current guidelines for all children with potential AHT, particularly those younger than 2 years; For an acutely ill child with neurologic impairment, an optimal imaging strategy involves initial unenhanced CT with 3-D reformatted images of the calvarium, followed by a full multi-sequence MRI of the brain and the cervical, thoracic and lumbar spine as soon as feasible; Suspicion of AHT warrants comprehensive imaging, and the decision rule developed from a network of emergency departments regarding the use of imaging in low-risk blunt head trauma (PECARN) does not apply for AHT.
