Abusive Head Trauma? A Biomechanics-Based Approach

Abstract

Medical professionals frequently evaluate infants and children with head trauma. If the child's cranial injuries are not explained by the history, child abuse must be considered. A significant body of research regarding cranial injury mechanisms is available. This article presents a synthesis of a subset of the biomechanics literature relevant to head injury. The potential application of this knowledge base is explored through five questions: (a) What physical laws govern the response of the head-brain complex to the application of a mechanical force? (b) What are the causal mechanisms of head injury? (c) What properties of living tissues affect responses to the application of a mechanical force? (d) How can specific cranial injuries be linked to their biomechanical origins? and (e) Can the biomechanical history explain the cranial injuries? The authors propose a biomechanics-based paradigm for analysis of pediatric head trauma and seek a qualitative rather than a quantitative understanding.