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  • Title: Occult cranial injuries found with neuroimaging in clinically asymptomatic young children due to abusive compared to accidental head trauma.
    Author: Fickenscher KA, Dean JS, Mena DC, Green BA, Lowe LH.
    Journal: South Med J; 2010 Feb; 103(2):121-5. PubMed ID: 20065898.
    Abstract:
    OBJECTIVE: To compare occult brain injuries on neuroimaging in clinically asymptomatic children under 20 months due to abusive versus accidental head trauma. SUBJECTS AND METHODS: A retrospective review of 58 children under 20 months who underwent neuroimaging for possible abusive trauma was performed. The data collected were demographics, neurological signs/symptoms, imaging findings, and disposition (abusive or accidental). RESULTS: The disposition of 31 subjects was abusive trauma and 27 were accidental. At presentation, 8/31(25.8%) children with abusive injury and 15/27(55.6%) with accidental injury were neurologically asymptomatic. Neuroimaging was abnormal in 6 of 8 (75.0%) asymptomatic children with abusive injury, and 13/15 (86.7%) children with accidental trauma. No significant (P = 0.59) difference in frequency of abnormal neuroimaging was seen between the asymptomatic abusive and accidental trauma groups. CONCLUSIONS: Although victims of abusive trauma under 20 months of age are less often neurologically asymptomatic compared to accidental trauma victims, neuroimaging revealed a high rate of occult traumatic brain injury in both groups.
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