Acute subdural hematoma in infants with abusive head trauma: A literature review

Hiroshi Karibe, Motonobu Kameyama, Toshiaki Hayashi, Ayumi Narisawa, Teiji Tominaga

Research output: Contribution to journalReview articlepeer-review

25 Citations (Scopus)


The number of cases with child abuse is increasing in Japan, and abusive head trauma (AHT) is a major cause of death in abused children. Child abuse has been recognized by the late 19th century, and widely accepted as battered child syndrome in the middle of the 20th century. As terms, there had been considerable mechanistic controversies between shaken-baby and -impact syndrome until the beginning of the 21st century. In recent years, AHT has been utilized as a less mechanistic term. Most of the characteristics of AHT in Japan have been similar to those in the United States as follows: infant is the most common victim, acute subdural hematoma (SDH) is the most common intracranial lesion, and retinal hemorrhage is often complicated. On the other hand, several characteristics have been different as follows: mother is the most common perpetrators, impact is a more common mechanism of trauma than shaking, and external trauma is more common reflecting the existence of impact. Since AHT as well as child abuse is a social pathological phenomenon influenced by victims, perpetrators, socioeconomic circumstances, and so on, various aspects of AHT as well as child abuse can be changed with times. Actually, a recent paper suggests such changes in infants with acute SDH due to AHT. In this review article, AHT, abusive infantile acute SDH in particular, are reviewed from the aspect of neurosurgical perspectives, including its mechanisms of trauma, biomechanics, clinical features, management, and prognosis, to update the trend in Japan.

Original languageEnglish
Pages (from-to)264-273
Number of pages10
JournalNeurologia medico-chirurgica
Issue number5
Publication statusPublished - 2016


  • Abusive head trauma
  • Acute subdural hematoma
  • Infant

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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