Subdural haemorrhage in infants: when are they non-accidental?

Abstract 

Subdural haemorrhage is relatively common in children under the age of 2 years. The most common cause is shaken baby syndrome. Paediatricians are often challenged to make this diagnosis with confidence. A clinician must approach this problem from a thorough understanding of the epidemiological, clinical, pathological features of the condition. He/she must work with a team of specialists in the field of child protection, and perform a minimum set of investigations to identify all associated features. Once the full clinical picture is evident, the team must make a decision as to whether child abuse has taken place. This must be made in the context of the explanations for injury given and the type, site and severity of injuries the child has received. This paper sets out recommendations for this process, and discusses the pitfalls along the way.

Keywords: subdural haemorrhage, child abuse, diagnosis, shaken baby syndrome

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• f1 E-mail: Kempam@cardiff.ac.uk