Table 2

Clinical indicators of abusive head trauma

AHTNon-discriminatoryNon-AHT
Neuroradiology
 Extra-axial haemorrhageSDH

  • ▶ Multiple

  • ▶ Interhemispheric

  • ▶ Convexity

  • ▶ Posterior fossa

  • ▶ SAH

  • ▶ Bilateral SDH

  • ▶ EDH

 Intracerebral features

  • ▶ Hypoxic ischaemic injury

  • ▶ Cerebral oedema

  • ▶ Parenchymal injury

History and clinical features
 History

  • ▶ No history of trauma

  • ▶ Low impact fall, with persistent neurological impairment

  • ▶ Out-of-hospital CPR

  • ▶ Initial history changes

  • ▶ Other trauma explanations

  • ▶ Low impact trauma, normal neurology

  • ▶ Late presentation

  • ▶ Sibling involvement

  • ▶ High impact trauma

 Clinical features

  • ▶ Rib fractures

  • ▶ Retinal haemorrhage

  • ▶ Apnoea

  • ▶ Seizures

  • ▶ Head and neck bruising

  • ▶ Skull fracture

 Retinal haemorrhage

  • ▶ Bilateral

  • ▶ Multilayered

  • ▶ Extend to periphery

  • ▶ Numerous

  • ▶ Other retinal features

Rare but when occur

  • ▶ Unilateral

  • ▶ Posterior pole

  • ▶ Scattered

  • ▶ Few in number

  • AHT, abusive head trauma; CPR, cardiopulmonary resuscitation; EDH; extradural haematoma; SAH, subarachnoid haemorrhage; SDH, subdural haematoma.