Occult head injury is common in children with concern for physical abuse
Background Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children
Gespeichert in:
| Veröffentlicht in: | Pediatric radiology 2018-08, Vol.48 (8), p.1123-1129 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1129 |
|---|---|
| container_issue | 8 |
| container_start_page | 1123 |
| container_title | Pediatric radiology |
| container_volume | 48 |
| creator | Boehnke, Mitchell Mirsky, David Stence, Nicholas Stanley, Rachel M. Lindberg, Daniel M. |
| description | Background
Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children |
| doi_str_mv | 10.1007/s00247-018-4128-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2025319569</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2024671504</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-bc422ad07e21b4ef10aab49013a7d2245937980db70c584ba68bc7ace299f3ff3</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMo7rr6A7xIwIuX6OSjTXOUxS9Y2IueQ5qmtks_1qRF9t-bpauC4Glg5pl3hgehSwq3FEDeBQAmJAGaEUFZRtIjNKeCM0KVyo7RHDhQAkKoGToLYQMAPKH8FM2YShPBEzZHz2trx2bAlTMFrrvN6He4Dtj2bdt3sYFtVTeFdx3-rIcq9jvrfIfL3uNttQu1NQ02-RjcOTopTRPcxaEu0Nvjw-vymazWTy_L-xWxXLKB5FYwZgqQjtFcuJKCMblQQLmRBWMiUVyqDIpcgk0ykZs0y6001jGlSl6WfIFuptyt7z9GFwbd1sG6pjGd68egGbCEU5WkKqLXf9BNP_oufrenRCppAiJSdKKs70PwrtRbX7fG7zQFvdesJ806atZ7zTqNO1eH5DFvXfGz8e01AmwCQhx1787_nv4_9QtnYYal</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2024671504</pqid></control><display><type>article</type><title>Occult head injury is common in children with concern for physical abuse</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Boehnke, Mitchell ; Mirsky, David ; Stence, Nicholas ; Stanley, Rachel M. ; Lindberg, Daniel M.</creator><creatorcontrib>Boehnke, Mitchell ; Mirsky, David ; Stence, Nicholas ; Stanley, Rachel M. ; Lindberg, Daniel M. ; ExSTRA investigators ; for the ExSTRA investigators</creatorcontrib><description>Background
Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children <2 years old with concern for physical abuse. The American College of Radiology (ACR) recommends clinicians have a low threshold to obtain neuroimaging in these patients.
Objectives
Our aim was to determine the prevalence of occult head injury in a large patient cohort with suspected physical abuse using similar selection criteria from previous studies. Additionally, we evaluated proposed risk factors for associations with occult head injury.
Materials and methods
This was a retrospective, secondary analysis of data collected by an observational study of 20 U.S. child abuse teams that evaluated children who underwent subspecialty evaluation for concern of abuse. We evaluated children <2 years old and excluded those with abnormal mental status, bulging fontanelle, seizure, respiratory arrest, underlying neurological condition, focal neurological deficit or scalp injury.
Results
One thousand one hundred forty-three subjects met inclusion criteria and 62.5% (714) underwent neuroimaging with either head computed tomography or magnetic resonance imaging. We found an occult head injury prevalence of 19.7% (141). Subjects with emesis (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.8–6.8), macrocephaly (OR 8.5, 95% CI 3.7–20.2), and loss of consciousness (OR 5.1, 95% CI 1.2–22.9) had higher odds of occult head injury.
Conclusion
Our results show a high prevalence of occult head injury in patients <2 years old with suspected physical abuse. Our data support the ACR recommendation that clinicians should have a low threshold to perform neuroimaging in patients <2 years of age.</description><identifier>ISSN: 0301-0449</identifier><identifier>EISSN: 1432-1998</identifier><identifier>DOI: 10.1007/s00247-018-4128-6</identifier><identifier>PMID: 29654352</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Child abuse & neglect ; Child Abuse - diagnosis ; Child Abuse - statistics & numerical data ; Children ; Computed tomography ; Confidence intervals ; Craniocerebral Trauma - diagnostic imaging ; Craniocerebral Trauma - epidemiology ; Data processing ; Female ; Head ; Head injuries ; Humans ; Imaging ; Infant ; Infant, Newborn ; Injuries ; Injury analysis ; Macrocephaly ; Magnetic Resonance Imaging ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Neuroimaging ; Neuroimaging - methods ; Neurology ; Neuroradiology ; Nuclear Medicine ; Oncology ; Original Article ; Patients ; Pediatrics ; Prevalence ; Radiology ; Retrospective Studies ; Risk analysis ; Risk Factors ; Scalp ; Secondary analysis ; Tomography, X-Ray Computed ; Ultrasound ; United States - epidemiology ; Vomiting</subject><ispartof>Pediatric radiology, 2018-08, Vol.48 (8), p.1123-1129</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Pediatric Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-bc422ad07e21b4ef10aab49013a7d2245937980db70c584ba68bc7ace299f3ff3</citedby><cites>FETCH-LOGICAL-c372t-bc422ad07e21b4ef10aab49013a7d2245937980db70c584ba68bc7ace299f3ff3</cites><orcidid>0000-0002-8370-5713</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00247-018-4128-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00247-018-4128-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29654352$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boehnke, Mitchell</creatorcontrib><creatorcontrib>Mirsky, David</creatorcontrib><creatorcontrib>Stence, Nicholas</creatorcontrib><creatorcontrib>Stanley, Rachel M.</creatorcontrib><creatorcontrib>Lindberg, Daniel M.</creatorcontrib><creatorcontrib>ExSTRA investigators</creatorcontrib><creatorcontrib>for the ExSTRA investigators</creatorcontrib><title>Occult head injury is common in children with concern for physical abuse</title><title>Pediatric radiology</title><addtitle>Pediatr Radiol</addtitle><addtitle>Pediatr Radiol</addtitle><description>Background
Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children <2 years old with concern for physical abuse. The American College of Radiology (ACR) recommends clinicians have a low threshold to obtain neuroimaging in these patients.
Objectives
Our aim was to determine the prevalence of occult head injury in a large patient cohort with suspected physical abuse using similar selection criteria from previous studies. Additionally, we evaluated proposed risk factors for associations with occult head injury.
Materials and methods
This was a retrospective, secondary analysis of data collected by an observational study of 20 U.S. child abuse teams that evaluated children who underwent subspecialty evaluation for concern of abuse. We evaluated children <2 years old and excluded those with abnormal mental status, bulging fontanelle, seizure, respiratory arrest, underlying neurological condition, focal neurological deficit or scalp injury.
Results
One thousand one hundred forty-three subjects met inclusion criteria and 62.5% (714) underwent neuroimaging with either head computed tomography or magnetic resonance imaging. We found an occult head injury prevalence of 19.7% (141). Subjects with emesis (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.8–6.8), macrocephaly (OR 8.5, 95% CI 3.7–20.2), and loss of consciousness (OR 5.1, 95% CI 1.2–22.9) had higher odds of occult head injury.
Conclusion
Our results show a high prevalence of occult head injury in patients <2 years old with suspected physical abuse. Our data support the ACR recommendation that clinicians should have a low threshold to perform neuroimaging in patients <2 years of age.</description><subject>Child abuse & neglect</subject><subject>Child Abuse - diagnosis</subject><subject>Child Abuse - statistics & numerical data</subject><subject>Children</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Craniocerebral Trauma - diagnostic imaging</subject><subject>Craniocerebral Trauma - epidemiology</subject><subject>Data processing</subject><subject>Female</subject><subject>Head</subject><subject>Head injuries</subject><subject>Humans</subject><subject>Imaging</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Macrocephaly</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroimaging</subject><subject>Neuroimaging - methods</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prevalence</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Scalp</subject><subject>Secondary analysis</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasound</subject><subject>United States - epidemiology</subject><subject>Vomiting</subject><issn>0301-0449</issn><issn>1432-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1LxDAQhoMo7rr6A7xIwIuX6OSjTXOUxS9Y2IueQ5qmtks_1qRF9t-bpauC4Glg5pl3hgehSwq3FEDeBQAmJAGaEUFZRtIjNKeCM0KVyo7RHDhQAkKoGToLYQMAPKH8FM2YShPBEzZHz2trx2bAlTMFrrvN6He4Dtj2bdt3sYFtVTeFdx3-rIcq9jvrfIfL3uNttQu1NQ02-RjcOTopTRPcxaEu0Nvjw-vymazWTy_L-xWxXLKB5FYwZgqQjtFcuJKCMblQQLmRBWMiUVyqDIpcgk0ykZs0y6001jGlSl6WfIFuptyt7z9GFwbd1sG6pjGd68egGbCEU5WkKqLXf9BNP_oufrenRCppAiJSdKKs70PwrtRbX7fG7zQFvdesJ806atZ7zTqNO1eH5DFvXfGz8e01AmwCQhx1787_nv4_9QtnYYal</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Boehnke, Mitchell</creator><creator>Mirsky, David</creator><creator>Stence, Nicholas</creator><creator>Stanley, Rachel M.</creator><creator>Lindberg, Daniel M.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8370-5713</orcidid></search><sort><creationdate>20180801</creationdate><title>Occult head injury is common in children with concern for physical abuse</title><author>Boehnke, Mitchell ; Mirsky, David ; Stence, Nicholas ; Stanley, Rachel M. ; Lindberg, Daniel M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-bc422ad07e21b4ef10aab49013a7d2245937980db70c584ba68bc7ace299f3ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Child abuse & neglect</topic><topic>Child Abuse - diagnosis</topic><topic>Child Abuse - statistics & numerical data</topic><topic>Children</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Craniocerebral Trauma - diagnostic imaging</topic><topic>Craniocerebral Trauma - epidemiology</topic><topic>Data processing</topic><topic>Female</topic><topic>Head</topic><topic>Head injuries</topic><topic>Humans</topic><topic>Imaging</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Macrocephaly</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroimaging</topic><topic>Neuroimaging - methods</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Prevalence</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Scalp</topic><topic>Secondary analysis</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasound</topic><topic>United States - epidemiology</topic><topic>Vomiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boehnke, Mitchell</creatorcontrib><creatorcontrib>Mirsky, David</creatorcontrib><creatorcontrib>Stence, Nicholas</creatorcontrib><creatorcontrib>Stanley, Rachel M.</creatorcontrib><creatorcontrib>Lindberg, Daniel M.</creatorcontrib><creatorcontrib>ExSTRA investigators</creatorcontrib><creatorcontrib>for the ExSTRA investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boehnke, Mitchell</au><au>Mirsky, David</au><au>Stence, Nicholas</au><au>Stanley, Rachel M.</au><au>Lindberg, Daniel M.</au><aucorp>ExSTRA investigators</aucorp><aucorp>for the ExSTRA investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Occult head injury is common in children with concern for physical abuse</atitle><jtitle>Pediatric radiology</jtitle><stitle>Pediatr Radiol</stitle><addtitle>Pediatr Radiol</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>48</volume><issue>8</issue><spage>1123</spage><epage>1129</epage><pages>1123-1129</pages><issn>0301-0449</issn><eissn>1432-1998</eissn><abstract>Background
Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children <2 years old with concern for physical abuse. The American College of Radiology (ACR) recommends clinicians have a low threshold to obtain neuroimaging in these patients.
Objectives
Our aim was to determine the prevalence of occult head injury in a large patient cohort with suspected physical abuse using similar selection criteria from previous studies. Additionally, we evaluated proposed risk factors for associations with occult head injury.
Materials and methods
This was a retrospective, secondary analysis of data collected by an observational study of 20 U.S. child abuse teams that evaluated children who underwent subspecialty evaluation for concern of abuse. We evaluated children <2 years old and excluded those with abnormal mental status, bulging fontanelle, seizure, respiratory arrest, underlying neurological condition, focal neurological deficit or scalp injury.
Results
One thousand one hundred forty-three subjects met inclusion criteria and 62.5% (714) underwent neuroimaging with either head computed tomography or magnetic resonance imaging. We found an occult head injury prevalence of 19.7% (141). Subjects with emesis (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.8–6.8), macrocephaly (OR 8.5, 95% CI 3.7–20.2), and loss of consciousness (OR 5.1, 95% CI 1.2–22.9) had higher odds of occult head injury.
Conclusion
Our results show a high prevalence of occult head injury in patients <2 years old with suspected physical abuse. Our data support the ACR recommendation that clinicians should have a low threshold to perform neuroimaging in patients <2 years of age.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29654352</pmid><doi>10.1007/s00247-018-4128-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8370-5713</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0301-0449 |
| ispartof | Pediatric radiology, 2018-08, Vol.48 (8), p.1123-1129 |
| issn | 0301-0449 1432-1998 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2025319569 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Child abuse & neglect Child Abuse - diagnosis Child Abuse - statistics & numerical data Children Computed tomography Confidence intervals Craniocerebral Trauma - diagnostic imaging Craniocerebral Trauma - epidemiology Data processing Female Head Head injuries Humans Imaging Infant Infant, Newborn Injuries Injury analysis Macrocephaly Magnetic Resonance Imaging Male Medical imaging Medicine Medicine & Public Health Neuroimaging Neuroimaging - methods Neurology Neuroradiology Nuclear Medicine Oncology Original Article Patients Pediatrics Prevalence Radiology Retrospective Studies Risk analysis Risk Factors Scalp Secondary analysis Tomography, X-Ray Computed Ultrasound United States - epidemiology Vomiting |
| title | Occult head injury is common in children with concern for physical abuse |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T21%3A24%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Occult%20head%20injury%20is%20common%20in%20children%20with%20concern%20for%20physical%20abuse&rft.jtitle=Pediatric%20radiology&rft.au=Boehnke,%20Mitchell&rft.aucorp=ExSTRA%20investigators&rft.date=2018-08-01&rft.volume=48&rft.issue=8&rft.spage=1123&rft.epage=1129&rft.pages=1123-1129&rft.issn=0301-0449&rft.eissn=1432-1998&rft_id=info:doi/10.1007/s00247-018-4128-6&rft_dat=%3Cproquest_cross%3E2024671504%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2024671504&rft_id=info:pmid/29654352&rfr_iscdi=true |