Table 2.
The PediBIRN network’s a priori definitional criteria for pediatric abusive head trauma.
| Patients meeting any one or more of these criteria were sorted as AHT. |
|---|
| • Primary caregivera admission of abusive acts |
| • Abusive acts by the primary caregivera that were witnessed by an unbiased, independent observer |
| • Specific primary caregivera denial of any head trauma, even though the pre-ambulatory child in his or her care became acutely, clearly and persistently ill with clinical signs subsequently linked to traumatic cranial injuries visible on CT or MR imaging |
| • Primary caregivera account of the child’s head injury event that was clearly historically inconsistent with repetition over time |
| • Primary caregivera account of the child’s head injury event that was clearly developmentally inconsistent with child’s known (or expected) gross motor skills |
| • Two or more categories of extra-cranial injuries considered moderately or highly suspicious for abuseb |
Abbreviations: AHT=abusive head trauma, CT=computed tomography, MR=magnetic resonance, PediBIRN=pediatric brain injury research network
Defined as the person responsible for the child when he or she was acutely head injured and/or first became clearly and persistently ill with clinical signs subsequently linked to traumatic cranial injuries visible on CT or MR imaging.
Including classic metaphyseal lesion fracture(s) or epiphyseal separation(s); rib fracture(s); fracture(s) of the scapula or sternum; fracture(s) of digits; vertebral body fracture(s), dislocation(s) or fracture(s) of spinous process(es); skin bruising, abrasion(s) or laceration(s) in two or more distinct locations other than knees, shins or elbows; patterned skin bruising or dry contact burn(s); scalding burn(s) with uniform depth, clear lines of demarcation and paucity of splash marks; confirmed intra-abdominal injuries; retinoschisis confirmed by an ophthalmologist; retinal hemorrhages described by an ophthalmologist as dense, extensive, covering a large surface area and/or extending to the ora serrata.