‘Compressed Baby Head’: A New ‘Abusive Head Trauma’ Entity?

Author:

Macorano Enrica1ORCID,Gentile Mattia2,Stellacci Giandomenico3,Manzionna Mariano4,Mele Federica1ORCID,Calvano Mariagrazia1,Leonardelli Mirko1,Duma Stefano1ORCID,De Gabriele Giovanni1,Cristalli Alessandro1,Minella Raffaella5,Di Fazio Aldo6,Introna Francesco1

Affiliation:

1. Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari ‘Aldo Moro’, 70124 Bari, Italy

2. Medical Genetics, Maternal and Child Department, Hospital of Venus, 70012 Bari, Italy

3. Unit of Paediatric Imaging, Giovanni XXIII Hospital, 70126 Bari, Italy

4. Complex Operating Unit, Paediatric and Neonatology, San Paolo Hospital, ASL Bari, 70100 Bari, Italy

5. School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool L3 5UX, UK

6. Regional Complex Intercompany Institute of Legal Medicine, 85100 Potenza, Italy

Abstract

Background: Child abuse represents an important issue in the medico-legal and social context. In the last few decades, various aspects and mechanisms have been identified in child abuse case studies; however, constant research is needed in the field. With this paper, the authors will present a case of a new entity of Abusive Head Trauma that has come to the attention of medico-legal experts. Discussion: The trauma analysis performed on the cranio-encephalic district of the baby revealed quite peculiar lesions that led the authors to exclude that the injuries had been solely caused by violent shaking of the baby’s head, as suggested by Shaken Baby Syndrome. Instead, the authors hypothesised that another lesion mechanism had been added to this one, namely latero-lateral cranial compression. The comprehensive and exhaustive analysis of the case led the authors to present a new possible entity in child abuse trauma, namely ‘Compressed Baby Head’. Conclusions: To the best of our knowledge, in the current literature, no similar clinical cases have ever been described. Thus, the case’s uniqueness deserves to be brought to the attention of experts and the entire scientific community, as well as medical personnel, paediatricians, and reanimators. These professional figures are the first individuals who may encounter complex clinical cases such as the one presented in this paper; thus, they need to know how to properly manage the case and ensure protection for the abused infants and children.

Funder

Section of Legal Medicine, University of Bari

Publisher

MDPI AG

Subject

Pediatrics, Perinatology and Child Health

Reference38 articles.

1. Yoon, S., Lee, J., Jun, Y.H., and Jeon, G.W. (2022). Neonatal Abusive Head Trauma without External Injuries: Suspicion Improves Diagnosis. Children, 9.

2. Aspetti radiologici e medico-legali dei traumi da maltrattamento sui minori;Solarino;Radiol. Med.,2009

3. U.S. Department of Health and Human Services (2020, January 01). Child Maltreatment 2018. HHS Website, Available online: https://www.acf.hhs.gov/sites/default/files/cb/cm2018.

4. The classic: Multiple fractures in the long bones of infants suffering from chronic subdural hematoma;Caffey;Clin. Orthop. Relat. Res.,2011

5. Shaken baby syndrome: A review of 20 cases;Ludwig;Ann. Emerg. Med.,1984

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