Diagnosis can be difficult as symptoms may be nonspecific. A CT scan of the head is typically recommended if a concern is present. It is unclear how useful subdural haematoma, retinal hemorrhages, and encephalopathy are alone at making the diagnosis. File:AbusiveheadtraumaBonewindowsNo.A skull fracture from abusive head trauma in an infant File:SkullFracAHTLtMark2.3D CT reconstruction showing a skull fracture in an infant File:SkullFracAHTMark.3D CT reconstruction showing a skull fracture in an infant Triad While the findings of<unk>  are complex and many, they are often incorrectly referred to as a "triad" for legal proceedings; distilled down to retinal hemorrhages, subdural hematomas, and encephalopathy.<unk>  may be misdiagnosed, underdiagnosed, and overdiagnosed, and caregivers may lie or be unaware of the mechanism of injury. Commonly, there are no externally visible signs of the condition. Examination by an experienced ophthalmologist is critical in diagnosing<unk> , as particular forms of ocular bleeding are strongly associated with AHT. Magnetic resonance imaging may also depict retinal hemorrhaging but is much less sensitive than an eye exam. Conditions that are often excluded by clinicians include hydrocephalus, sudden infant death syndrome (SIDS), seizure disorders, and infectious or congenital diseases like meningitis and metabolic disorders. CT scanning and magnetic resonance imaging are used to diagnose the condition. Conditions that often accompany<unk> /AHT include classic patterns of skeletal fracturing (rib fractures, corner fractures), injury to the cervical spine (in the neck), retinal hemorrhage, cerebral bleed or atrophy, hydrocephalus, and papilledema (swelling of the optic disc). The terms non-accidental head injury or inflicted traumatic brain injury have been used in place of "abusive head trauma" or "SBS". Classification The term abusive head trauma (AHT) is preferred as it better represents the broader potential causes. The US Centers for Disease Control and Prevention identifies<unk>  as "an injury to the skull or intracranial contents of an infant or young child (< 5 years of age) due to inflicted blunt impact and/or violent<unk> g". In 2009, the American Academy of Pediatrics recommended the use of the term AHT to replace<unk> , in part to differentiate injuries arising solely from<unk> g and injuries arising from<unk> g as well as trauma to the head. The Crown Prosecution Service for England and Wales recommended in 2011 that the term<unk>  be avoided and the term non accidental head injury (NAHI) be used instead. Controversy Efforts to create doubt about AHT include the mischaracterization and replacement of the complex diagnostic process by a near mechanical determination based on the “triad” — the findings of subdural hemorrhage, retinal hemorrhage and encephalopathy. This critique has been sensationalized in the mass media in an attempt to create the appearance of a “medical controversy” where there is none. The straw man “triad” argument ignores the fact that the AHT diagnosis typically is made only after careful consideration of all historical, clinical and laboratory findings as well as radiologic investigations by the collaboration of a multidisciplinary team. Differential diagnosis Vitamin C deficiency Some authors have suggested that certain cases of suspected<unk>  may result from vitamin C deficiency. This contested hypothesis is based upon a speculated marginal, near scorbutic condition or lack of essential nutrient(s) repletion and a potential elevated histamine level. However, symptoms consistent with increased histamine levels, such as low blood pressure and allergic symptoms, are not commonly associated with scurvy as clinically significant vitamin C deficiency. A literature review of this hypothesis in the journal Pediatrics International concluded the following: "From the available information in the literature, concluded that there was no convincing evidence to conclude that vitamin C deficiency can be considered to be a cause of<unk> ." The proponents of such hypotheses often question the adequacy of nutrient tissue levels, especially vitamin C, for those children currently or recently ill, bacterial infections, those with higher individual requirements, those suffering from environmental challenges (e.g. allergies), and perhaps transient vaccination-related stresses. At the time of this writing, infantile scurvy in the United States is practically nonexistent. No cases of scurvy mimicking<unk>  or sudden infant death syndrome have been reported, and scurvy typically occurs later in infancy, rarely causes death or intracranial bleeding, and is accompanied by other changes of the bones and skin and invariably an unusually deficient dietary history. In one study vaccination was shown not associated with retinal hemorrhages. Gestational problems Gestational problems affecting both mother and fetus, the birthing process, prematurity and nutritional deficits can accelerate skeletal and hemorrhagic pathologies that can also mimic<unk> , even before birth.
Shaken baby syndrome
Neonatal meningitis
Michelin tire baby syndrome
Blue baby syndrome
Neonatal stroke
Omphalitis of newborn
Gray baby syndrome
Neonatal diabetes