CHILD ABUSE (Non-accidental trauma)

      Unfortunately, there are over a million cases of child abuse in the United States each year. Intracranial injuries may be the result of either direct blows to the head, shaking, whiplash, or strangulation. The presence of an inner hemispheric subdural hematoma is often a tip-off of underlying abuse as it results usually from a whiplash type of injury rather than from a direct blow. There may also be associated subarachnoid hemorrhage as well as subdural hematomas or even subdural hygromas of different ages. One should also be alert for possible underlying non-accidental trauma in the presence of multiple fractures often of different ages. Cerebral anoxia and/or infarction (reversal sign) can occur as a result of strangulation. One should be on the alert for other sites of injury throughout the body.

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