Sacco Matteo Antonio, Gualtieri Saverio, Tarda Lucia, Ricci Pietrantonio, Aquila Isabella
Institute of Legal Medicine, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100 Catanzaro, Italy.
Diagnostics (Basel). 2023 Sep 29;13(19):3093. doi: 10.3390/diagnostics13193093.
Abusive head trauma (AHT) represents a very serious global public health problem. Prevention of these episodes is essential to reduce the morbidity and mortality of this phenomenon. All healthcare professionals should be able to recognize the signs of abuse. However, diagnosis is very complex as the signs are often blurred and cannot be recognized with certainty without carrying out adequate instrumental investigations. It has been calculated that approximately one-third of AHT cases remain undetected and require more than one medical visit to be correctly interpreted and diagnosed. On the other hand, the literature has recently also emphasized the problems related to possible false diagnoses of abuse and the numerous family and personal repercussions that follow from this issue. For these reasons, correct and timely recognition is essential to avoid the risk of recurrence of AHT and to start proper forensic investigations, in order to identify the offender or exonerate a suspect. The present work explores the most recent evidence of recent years in the field of AHT diagnostics through a literature review. The purpose of this article is to provide forensic pathologists with clear tools for diagnosis based on the literature. To this end, the review suggests clinical and forensic protocols aimed at the timely diagnosis of AHT in order to prevent abuse from remaining undetected.
虐待性头部创伤（AHT）是一个非常严重的全球公共卫生问题。预防这些事件对于降低这一现象的发病率和死亡率至关重要。所有医疗保健专业人员都应能够识别虐待迹象。然而，诊断非常复杂，因为这些迹象往往模糊不清，若不进行充分的仪器检查就无法确定识别。据计算，大约三分之一的AHT病例未被发现，需要不止一次就诊才能得到正确解读和诊断。另一方面，最近的文献也强调了与虐待可能的误诊相关的问题以及由此产生的众多家庭和个人影响。出于这些原因，正确及时的识别对于避免AHT复发风险以及启动适当的法医调查以确定犯罪者或免除嫌疑人罪责至关重要。本研究通过文献综述探讨了近年来AHT诊断领域的最新证据。本文的目的是根据文献为法医病理学家提供明确的诊断工具。为此，该综述提出了旨在及时诊断AHT的临床和法医方案，以防止虐待行为未被发现。
