Occult head injuries in infants evaluated for physical abuse

Abstract Background Abusive head injuries in infants may be occult but clinically or forensically important. Data conflict regarding yield of neuroimaging in detecting occult head injuries in infants evaluated for physical abuse, with prior studies identifying yields of 4.3–37.3 %. Objectives (1) To quantify yield of computed tomography or magnetic resonance imaging in identification of occult head injuries in infants with concerns for physical abuse and (2) to evaluate risk factors for occult head injuries. Participants and Setting We conducted a retrospective, stratified, random systematic sample of 529 infants Methods Sampling weights were applied to calculate proportions of infants with occult head injuries. We evaluated for associations between hypothesized risk factors (age Results Of 169 neurologically normal infants evaluated for abuse, occult head injury was identified in 6.5 % (95 % CI: 2.6, 15.8). Infants Conclusions Occult head injuries were less frequent than previously reported in some studies, but were identified in 1 in 10 infants