Abusive Head Trauma: A Review of Current Knowledge

Abusive head trauma is a specific type of child maltreatment associated with high morbidity and mortality rates that can be challenging to diagnose as there is often no history or a fabricated one. Including the diagnosis in a differential requires a high level of suspicion from frontline providers especially when the clinical presentation is subtle as signs and symptoms can mimic other common conditions in pediatrics. This may result in a delayed or missed diagnosis. A thorough and comprehensive history and physical exam and complete documentation are essential for timely diagnosis. Consultation with a child abuse pediatrician is recommended if available. This article reviews current knowledge of the epidemiology, presenting signs and symptoms, clinical findings, and differential diagnosis of abusive head trauma with a focus on relevant information for the emergency department care provider.