Child's Nervous System

, Volume 28, Issue 6, pp 889–896

Early clinical indicators of developmental outcome in abusive head trauma

  • Mary V. Greiner
  • Alice P. Lawrence
  • Paul Horn
  • Amy J. Newmeyer
  • Kathi L. Makoroff
Original Paper

DOI: 10.1007/s00381-012-1714-z

Cite this article as:
Greiner, M.V., Lawrence, A.P., Horn, P. et al. Childs Nerv Syst (2012) 28: 889. doi:10.1007/s00381-012-1714-z

Abstract

Purpose

The purpose of the study was to determine the developmental prognostic significance of early clinical indicators in abusive head trauma.

Methods

Seventy-one children were diagnosed with abusive head trauma and followed in a post-injury growth and development clinic. A retrospective chart review was completed to gather clinical features at the time of injury, including presence or absence of early post-traumatic seizures, presence or absence of intubation, and presence or absence of pediatric intensive care unit admission. Children then underwent developmental testing with use of the Capute Scales of the Cognitive Adaptive Test (CAT) and the Clinical Linguistic and Auditory Milestone Scale (CLAMS) during follow-up clinic visits. Clinical features at initial injury were compared to developmental outcome.

Results

Thirty-four of 71 patients with seizures during their admission hospitalization scored significantly lower on follow-up developmental testing than patients who did not have seizures. Twenty-one of 71 patients who required intubation scored lower on developmental testing than patients who did not require intubation. Thirty-five of 71 patients who required pediatric intensive care unit admission scored lower on developmental testing than patients who did not require pediatric intensive care unit admission.

Conclusions

This study demonstrates that clinical factors at the time of injury, such as early post-traumatic seizures and intubation requirement, are associated with poorer developmental outcome. This study also suggests that close developmental follow-up should be obtained for all children with abusive head trauma, regardless of whether or not the child was admitted to the PICU.

Keywords

AbuseDevelopmental outcomeHead traumaIntensive careSeizure

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Mary V. Greiner
    • 1
  • Alice P. Lawrence
    • 2
  • Paul Horn
    • 1
  • Amy J. Newmeyer
    • 3
  • Kathi L. Makoroff
    • 1
  1. 1.Department of PediatricsCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Department of PediatricsChildren’s Hospital of VanderbiltNashvilleUSA
  3. 3.Department of PediatricsChildren’s Hospital of the King’s DaughterNorfolkUSA