title: Clinical clues for head injuries amongst Malaysian infants: accidental or non-accidental?
abstract: Identifying the differences between infants with non-accidental head injuries (NAHI) and accidental head injuries (AHI) may help alert clinicians to recognize markers of abuse. A retrospective review of infants <1 year of age admitted to a tertiary referral centre in Malaysia over a two year period with a diagnosis of head injury or abnormal computed tomography head scans was conducted to identify the clinical features pointing towards a diagnosis of NAHI by comparing the socio-demographics, presenting complaints, clinical features and the extent of hospital investigations carried out. NAHI infants were more likely to be symptomatic, under a non-related caregiver's supervision, and presented with inconsistent or no known mechanism of injury. Subdural haemorrhages were more common in NAHI infants. The history, mechanism of injury, presenting signs and symptoms as well as the nature of the injuries sustained are all valuable clues as to whether a head injury sustained during infancy is likely to be accidental or not.
authors.affiliation: Department of Pediatrics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia. drmeerat@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Thalayasingam
authors.forename: A
authors.initials: A
authors.lastname: Veerakumarasivam
authors.forename: S
authors.initials: S
authors.lastname: Kulanthayan
authors.forename: F
authors.initials: F
authors.lastname: Khairuddin
authors.forename: I G S
authors.initials: IG
authors.lastname: Cheah
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D002649:Child Abuse / Q000706:statistics & numerical data*; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D003657:Decision Making; D005260:Female; D006408:Hematoma, Subdural / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D011237:Predictive Value of Tests; D012166:Retinal Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed