Non-accidental head trauma [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Non-accidental head trauma ======
 
Non-[[accident]]al [[head trauma]] (NAHT) is a common cause of [[traumatic brain injury]] in [[child]]hood, origin of profound and disabling neurological [[sequala]]e, and in the most disgraceful cases, ultimately [[death]].
[[Subdural hematoma]] (SDH) is the most common intracranial finding in Non-[[accident]]al [[head trauma]] (NAHT). On the other hand, [[congenital]] [[bleeding disorder]]s are a minor but a significant cause of ICH in the [[neonate]] and [[toddler]]. Not uncommonly, [[intracranial]] [[bleeding]] is the first sign of a severe inherited [[coagulation disorder]]. 
In the presence of an unexpected intracranial bleeding after a [[minor trauma]] or without a clear [[history]] of the related [[event]]s, [[physician]]s and [[caregiver]]s may be confronted to the [[dilemma]] of a possible [[child abuse]]. It must be bear in mind that physical abuse and bleeding disorders can co-exist in the same child.

Hinojosa et al. reported the case of two [[sibling]]s in whom a [[diagnosis]] of [[hemophilia]] coexisted with the presumption of a non-accidental head trauma. [[Child abuse]]s were inflicted in both [[child]]ren with a spare time of 2 years. A diagnosis of mild hemophilia was prompted in the first sibling after initial NAHT, while inflicted trauma was evident in the second sibling after [[neuroimaging]] findings and concomitant lesions. Lessons from this case in co-existing bleeding disorders and inflicted trauma and legal implications derived will be discussed thereafter.The possibility of a bleeding disorder should be considered in all children presenting with unexplained bleeding at a critical site in the setting of suspected physical maltreatment, particularly [[intracranial hemorrhage]] (ICH)
((Hinojosa J, Simó M, Armero G, Becerra MV, Alamar M, Candela S, Culebras D, Muchart J, Berrueco R. [[Hemophilia]] and [[non-accidental head trauma]] in two [[sibling]]s: [[lesson]]s and [[legal]] [[implication]]s. Childs Nerv Syst. 2022 Oct 28. doi: 10.1007/s00381-022-05713-2. Epub ahead of print. PMID: 36303077.)).