Challenges in Prevention of Abusive Head Trauma
In the early 1970s, Caffey described infants exposed to physical child abuse with subdural hemorrhages, retinal hemorrhages, and fractures, a pattern of injuries he attributed to whiplash shaken infant syndrome. Noting the significant risk for morbidity and mortality associated with the intracranial injuries, Caffey called for a nationwide educational campaign against the shaking, slapping, jerking, and jolting of infants’ heads. Over the past 40 years, the terminology used to describe these traumatic brain injuries has changed. Our understanding of the epidemiology and risk factors for abusive head trauma (AHT) has increased. We have also seen significant advances in the diagnosis and medical management of these injuries, but we are still grappling with how to prevent them.