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AAP Grand Rounds 12:47 (2004) Distinguishing Abusive from Accidental Head TraumaSource: Bechtel K, Stoessel K, Leventhal JM, et al. Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics. 2004;114:165168.
A majority of children under the age of 2 who have serious or fatal head trauma have been victims of abuse.1,2 Nevertheless, major head injuries may occur in this same age group from accidental causes. These authors present a prospective study of children less than 2 years of age who were hospitalized at Yale-New Haven Childrens Hospital, Conn, with a diagnosis of head injury and who had computed tomography of the head performed as part of their evaluation. The children were classified as victims of inflicted or accidental head trauma based upon predetermined criteria that did not include the presence or absence of retinal hemorrhages. All patients in the study underwent a dilated ophthalmologic examination by a pediatric ophthalmologist.
The 67 children in the
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