Consensus Statement on Abusive Head Trauma in Infants and Young Children

48 Pediatric Radiology, 1048, 1065 (2018), (with Choudhary, A.K., Servaes, S., Slovis, T.L. et al).

Florida International University Legal Studies Research Paper No. 19-07

Posted: 10 May 2019 Last revised: 12 May 2019

See all articles by Joelle Anne Moreno

Joelle Anne Moreno

Florida International University (FIU) - College of Law

Date Written: 2018

Abstract

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic–ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.

Keywords: Abusive head trauma, Child abuse, Children, Computed tomography, Consensus statement, Infants, Magnetic resonance imaging, Mimics, Unsubstantiated theories

Suggested Citation

Moreno, Joelle Anne, Consensus Statement on Abusive Head Trauma in Infants and Young Children (2018). 48 Pediatric Radiology, 1048, 1065 (2018), (with Choudhary, A.K., Servaes, S., Slovis, T.L. et al).; Florida International University Legal Studies Research Paper No. 19-07. Available at SSRN: https://ssrn.com/abstract=3385564

Joelle Anne Moreno (Contact Author)

Florida International University (FIU) - College of Law ( email )

11200 SW 8th St.
RDB Hall 1097
Miami, FL 33199
United States
305-348-1152 (Phone)
305-348-7293 (Fax)

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