title: Late outcome following central nervous system injury in child abuse.
abstract: OBJECTIVE
  The object of this study was to increase our understanding of the social, clinical, radiographic and psychological consequences of child abuse after the initial insult and to describe the role of neurosurgery and other specialties in this context.
  
  
  METHODS
  A review of the literature on child abuse (using scientific journals, textbooks, and internet reports) was conducted, with special attention given to child abuse in infants. The biomechanical patterns of injury, the long-term neurological, psychological, and social outcomes and methods of rehabilitation are reviewed.
  
  
  CONCLUSIONS
  Head injury associated with physical abuse carries a significantly worse clinical outcome than accidental trauma. Late findings in CT scans and MRI show evidence of cerebral atrophy in 100% and cerebral ischemia in 50% of physical abuse cases. Abuse and neglect have a strong impact in developing children, producing emotional, cognitive, and social problems that may persist throughout the rest of their lives. Outcome cannot be improved without an integrated rehabilitation strategy encompassing early field management, hospital therapy, precise targeting of educational and cognitive needs, and finally return to the community. New ancillary tests have emerged that are aimed at improving rehabilitation and illuminating the long-term physiological and functional impact of abuse.
authors.affiliation: Department of Neurological Surgery, Wayne State University, Detroit, Michigan, USA. eperez@neurosurgery.wayne.edu
authors.forename: Eimir
authors.initials: E
authors.lastname: Perez-Arjona
authors.forename: Manuel
authors.initials: M
authors.lastname: Dujovny
authors.forename: Zachary
authors.initials: Z
authors.lastname: DelProposto
authors.forename: Federico
authors.initials: F
authors.lastname: Vinas
authors.forename: Hun
authors.initials: H
authors.lastname: Park
authors.forename: Sandra
authors.initials: S
authors.lastname: Lizarraga
authors.forename: Thomas
authors.initials: T
authors.lastname: Park
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Diaz
mesh_terms: D002493:Central Nervous System Diseases / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D002649:Child Abuse; D002653:Child Behavior Disorders / Q000209:etiology; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000209:etiology; D007859:Learning Disabilities / Q000209:etiology; D008569:Memory Disorders / Q000209:etiology; D017063:Outcome Assessment, Health Care; D012166:Retinal Hemorrhage / Q000209:etiology; D020196:Trauma, Nervous System / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation