Citation

Wester K, Stridbeck U, Syse A, Wikström J. Acta Paediatr. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, John Wiley and Sons)

DOI

10.1111/apa.15956

PMID

unavailable

Abstract

AIM: The criteria for diagnosing abusive head trauma (AHT) are not well defined and this condition might be diagnosed on failing premises. Our aim was to review criminal AHT cases in Norwegian courts by scrutinising the underlying medical documentation.

METHODS: Cases were identified in the data registry for Norwegian courts 2004-2015. Documentation was obtained from relevant health institutions. The medical co-authors first made independent evaluations of the documentation for each child, followed by a consensus evaluation.

RESULTS: A total of seventeen children (11 boys) were identified, all diagnosed as AHT by court appointed experts, 15 were infants (mean age 2.6 months). A high proportion (41.2%) was born to immigrant parents and 31.3% were premature. The medical findings could be explained by alternative diagnoses in 16 of the 17 children; eight boys (7 infants - mean age 2.9 months) had clinical and radiological characteristics compatible with external hydrocephalus complicated by chronic subdural haematoma. Six children (five infants with mean age 2.1 months) had a female preponderance and findings compatible with hypoxic ischaemic insults (HII).

CONCLUSION: The medical condition in most children had not necessarily been caused by shaking or direct impact, as was originally concluded by the court experts.

Language: en

Keywords

child abuse; shaken baby syndrome; abusive head trauma; benign external hydrocephalus; subdural haematoma