Shaahinfar Ashkon, Whitelaw Kevin D, Mansour Karim M
aDepartment of Emergency Medicine, UCSF Benioff Children's Hospital Oakland, Oakland bDepartment of Emergency Medicine, UCSF, San Francisco, California, USA.
Curr Opin Pediatr. 2015 Jun;27(3):308-14. doi: 10.1097/MOP.0000000000000207.
This article provides an update on abusive head trauma (AHT), focusing on new developments most salient to the emergency medicine clinician, including epidemiology, clinical recognition, diagnostic work-up, management of neurologic injury, and public health implications.
The recent literature has focused on honing the clinician's ability to recognize AHT and its immediate sequelae, to more accurately distinguish between abusive and accidental head injuries by patterns of neuroimaging and retinal hemorrhages, and to appreciate the long-term impacts. Specifically, both a clinical prediction rule and biomarker show promise, and new research advocates for the early identification of subclinical seizures as well as cervical spine injuries.
The emergency medicine provider must be able to recognize and manage children who may have AHT and to appreciate when the diagnostic findings warrant consultation with a child protection team. These authors summarize the recent and notable advances in our understanding of AHT.
本文提供了关于虐待性头部创伤（AHT）的最新情况，重点关注对急诊医学临床医生最为重要的新进展，包括流行病学、临床识别、诊断检查、神经损伤的管理以及对公共卫生的影响。
最近的文献集中于提高临床医生识别AHT及其即时后遗症的能力，通过神经影像学和视网膜出血模式更准确地区分虐待性和意外性头部损伤，并认识到其长期影响。具体而言，临床预测规则和生物标志物都显示出前景，新的研究主张早期识别亚临床癫痫以及颈椎损伤。
急诊医学提供者必须能够识别和处理可能患有AHT的儿童，并明白何时诊断结果需要与儿童保护团队协商。这些作者总结了我们对AHT理解方面最近的显著进展。
