Child abuse & neglect · 2026
Cerebral, spinal, ophthalmological and skeletal findings associated with abusive and non-abusive head injury in children under 2 years old: A systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mattheij Marjolein A C, Van den Bosch Laura, Karst Wouter A, Bouziotis Jason, Dekeyzer Sven, Verdonck Thomas, Bekkering Geertruida, Janssens Eva, Ceulemans Berten, Monsieurs Koenraad G
Аннотация
BACKGROUND: Abusive head trauma (AHT) in children is challenging to diagnose due to unreliable histories and varying presentations and findings from additional examinations. Findings from additional examinations may help distinguish AHT from non-abusive head trauma (nAHT), but single studies report conflicting results.
OBJECTIVE: This systematic review (SR) synthesizes evidence on differences in additional examinations between children under 2 years with AHT and nAHT.
METHODS: We searched Ovid Medline, Web of Science, and the Cochrane Library for comparative observational studies to identify differences in cerebral, spinal, ophthalmological and skeletal findings between children with AHT and nAHT. Two reviewers independently selected studies, extracted data, and assessed risk of bias (RoB) using the Newcastle-Ottawa Scale. Random-effects meta-analyses and sensitivity analyses were performed.
RESULTS: Forty (mostly retrospective) studies reported 51 clinical variables. Eighteen variables were associated with AHT: subdural hemorrhage (SDH), bilateral SDH, interhemispheric blood, mixed-density SDH, multilayered SDH, any intracranial hemorrhage (ICH), ICH without skull fracture, cerebral edema, ischemia, and atrophy, hydrocephalus, spinal SDH, cervical and thoracolumbar spinal SDH, retinal hemorrhages (RH), bilateral RH, vitreous hemorrhage and skeletal fracture. The variables skull fracture, isolated skull fracture, epidural hemorrhage (EDH), subgaleal hematoma, and long bone fracture were associated with nAHT. Moderate or high RoB was observed in 69% of the assessments.
CONCLUSIONS: Certain cerebral, spinal, ophthalmological and skeletal features in children under 2 years with head injury may indicate AHT, with potential implications for accurate diagnosis and timely safeguarding. Results should be interpreted cautiously given the moderate to high RoB in the majority of assessments.
OBJECTIVE: This systematic review (SR) synthesizes evidence on differences in additional examinations between children under 2 years with AHT and nAHT.
METHODS: We searched Ovid Medline, Web of Science, and the Cochrane Library for comparative observational studies to identify differences in cerebral, spinal, ophthalmological and skeletal findings between children with AHT and nAHT. Two reviewers independently selected studies, extracted data, and assessed risk of bias (RoB) using the Newcastle-Ottawa Scale. Random-effects meta-analyses and sensitivity analyses were performed.
RESULTS: Forty (mostly retrospective) studies reported 51 clinical variables. Eighteen variables were associated with AHT: subdural hemorrhage (SDH), bilateral SDH, interhemispheric blood, mixed-density SDH, multilayered SDH, any intracranial hemorrhage (ICH), ICH without skull fracture, cerebral edema, ischemia, and atrophy, hydrocephalus, spinal SDH, cervical and thoracolumbar spinal SDH, retinal hemorrhages (RH), bilateral RH, vitreous hemorrhage and skeletal fracture. The variables skull fracture, isolated skull fracture, epidural hemorrhage (EDH), subgaleal hematoma, and long bone fracture were associated with nAHT. Moderate or high RoB was observed in 69% of the assessments.
CONCLUSIONS: Certain cerebral, spinal, ophthalmological and skeletal features in children under 2 years with head injury may indicate AHT, with potential implications for accurate diagnosis and timely safeguarding. Results should be interpreted cautiously given the moderate to high RoB in the majority of assessments.