NAI: never actually injured

2021 ◽  
Vol 14 (5) ◽  
pp. e240302
Author(s):  
David Kilgarriff ◽  
Sinead Brannick ◽  
Edwina Daly ◽  
Conor Ring
Keyword(s):  
Head Injury ◽  
Careful Consideration ◽  
Parietal Bone ◽  
Ct Imaging ◽  
Female Infant ◽  
Accidental Injury ◽  
Left Parietal Bone ◽  
Non Accidental Injury

A female infant presented at 31 days of life following a head injury with concerning features for non-accidental injury. Examination revealed a noticeable depression in the left temporoparietal region with a concave depression of the left parietal bone on CT imaging. After careful consideration of the history and examination findings, along with standard investigations for non-accidental injury, the infant was diagnosed with faulty fetal packing (also known as congenital vault depression). The defect had almost completely resolved by follow-up at 5 months. This case represented a diagnostic conundrum not previously reported in the literature.

scholarly journals Dural Plasmacytoma Involving Calvarium with Soft Tissue Extension Mimicking Meningioma: A Diagnostic Dilemma

2019 ◽  
Vol 08 (01) ◽  
pp. 053-056
Author(s):  
Anju Shukla ◽  
Devendra Chhabra ◽  
Tarun Pandey ◽  
Prashant Singh
Keyword(s):  
Soft Tissue ◽  
Postoperative Radiotherapy ◽  
Parietal Bone ◽  
Diagnostic Dilemma ◽  
Tissue Mass ◽  
Soft Tissue Extension ◽  
Dural Tail ◽  
Left Parietal Bone ◽  
Magnetic Resonance Imaging Mri

AbstractHere, the authors describe a case of 25-year-old man diagnosed with dural plasmacytoma involving calvarium with soft tissue extension. Magnetic resonance imaging (MRI) revealed extra-axial heterogeneously enhancing soft tissue mass lesion in the left parieto-occipital region with a dural tail mimicking meningioma, destroying the left parietal bone, and bulging into the scalp. Mass was excised and histopathologic examination revealed plasmacytoma with amyloid deposition. There is no recurrence after postoperative radiotherapy and 2 years of follow-up, although the future course is still not certain. The clinician should consider alternative diagnosis other than meningioma prior to proceeding to surgery if the dural-based lesion is involving calvarium and soft tissue extension.

scholarly journals Imaging the infant with a head injury: a single-centre retrospective study

2020 ◽  
Vol 4 (1) ◽  
pp. e000779
Author(s):  
Daniel Braunold ◽  
Hannah Lewis ◽  
Breda O'Neill ◽  
Naomi Edmonds
Keyword(s):  
Retrospective Study ◽  
Head Injury ◽  
Major Trauma ◽  
Risk Group ◽  
Trauma Centre ◽  
High Risk Group ◽  
Single Centre ◽  
Accidental Injury ◽  
Major Trauma Centre ◽  
Non Accidental Injury

Head injury is the largest cause of mortality in paediatric trauma. Infants (<1 year old) are a high-risk group and vulnerable to non-accidental injury. A single-centre retrospective study at a major trauma centre collected data on infants presenting with a head injury over a 48-month period. 1127 infants presented with a head injury. 135 CT heads were performed. 38% of scans showed intracranial pathology. The decision about which infants to send for CT scans remains complex. Liberal use risks over-exposure to ionising radiation while restrictive use may miss subtler injuries.

scholarly journals Head Injury and Mental Handicap

1983 ◽  
Vol 76 (7) ◽  
pp. 545-549 ◽  
Author(s):  
E O Akuffo ◽  
P E Sylvester
Keyword(s):  
Head Injury ◽  
Brain Function ◽  
Neurological Deficits ◽  
Pathological Study ◽  
Accidental Injury ◽  
Mental Handicap ◽  
Epileptic Patients ◽  
Non Accidental Injury ◽  
The Brain ◽  
Stay Hospital

A clinical and pathological study of head injury and the implications in mental handicap are outlined. Non-accidental injury as a form of child abuse is suspected as contributing considerably to the cause of mental handicap in populations resident in long-stay hospital, but this is unlikely to be the best environment for such patients. A number of mentally handicapped epileptic patients who injure their heads during fits and patients who repeatedly bang their heads as a feature of self-injurious behaviour are exposed to progressive neurological deficits associated with lesions in the brain which could further impair the efficiency of brain function.

Fifteen-minute consultation: The toddler’s fracture

2020 ◽  
pp. edpract-2020-319758
Author(s):  
Nils Wijtzes ◽  
Hannah Jacob ◽  
Katie Knight ◽  
Steffi Thust ◽  
Gayle Hann
Keyword(s):  
Child Protection ◽  
Weight Bearing ◽  
Tibial Shaft ◽  
Accidental Injury ◽  
Distinct Entity ◽  
Distal Shaft ◽  
Additional Imaging ◽  
Non Accidental Injury ◽  
Tibial Shaft Fractures

The toddler’s fracture is a distinct entity among tibial shaft fractures. It is defined as a minimally displaced or undisplaced spiral fracture, usually affecting the distal shaft of the tibia, with an intact fibula. They are often difficult to diagnose due to the absence of witnessed trauma and because initial radiographs may appear normal. Moreover, the presenting complaint (a non-weight bearing child) has a wide differential diagnosis. A detailed history and examination, together with additional imaging and other investigations, is crucial to diagnose a toddler’s fracture. Analgesia and immobilisation are the mainstays of treatment, with follow-up in fracture clinic recommended. Inflicted injury (Note: this article will use the term inflicted injury which is also called non-accidental injury. In the field of safeguarding, there is a move away from using the term ‘non-accidental injury’ due to misinterpretation of the term as being less serious than ‘abusive injury’ and that in child protection reports the term can be easily misread or mistyped as ‘accidental’ injury) should always be considered when red flags for child abuse are present. In this article, we aim to cover the differential diagnoses for toddler’s fracture including indicators that might suggest an inflicted injury.

The role of the follow-up chest radiograph in suspected non-accidental injury

2006 ◽  
Vol 36 (3) ◽  
pp. 216-218 ◽  
Author(s):  
Adikesavalu Anilkumar ◽  
Laura J. Fender ◽  
Nigel J. Broderick ◽  
John M. Somers ◽  
Katharine E. Halliday
Keyword(s):  
Chest Radiograph ◽  
Accidental Injury ◽  
Non Accidental Injury

Neonatal Head Injuries Revisited

2009 ◽  
Vol 54 (2) ◽  
pp. 34-36 ◽  
Author(s):  
J King ◽  
G Haddock
Keyword(s):  
Retrospective Study ◽  
Head Injury ◽  
Data Collection ◽  
Head Injuries ◽  
Structured Data ◽  
Ct Scans ◽  
Skull Fractures ◽  
Accidental Injury ◽  
Non Accidental Injury ◽  
Surgical Unit

Background Between 1999 and 2005, 51 neonates were admitted to the regional Neonatal Surgical Unit (NSU), Glasgow with a diagnosis of head injury. The aim of this retrospective study was to compare this cohort with those from an earlier review of similar cases. Methods and Results Cases were reviewed using a structured data collection proforma. Information obtained was then compared with the results of an identical review carried out in the same Unit between 1990 and 1996. In the present series, the majority of the injuries were caused by a fall (n=39 [78%]) and resulted in scalp haematomata (n=31 [62%]) and associated skull fractures (n=30 [60%]). Only one patient required significant intervention. Conclusion Comparing the two study periods, there has been a marked increase in the number of cases admitted with a diagnosis of head injury (n=51 v n=25). There has also been an increase in the number of intracranial haemorrhages reported, associated with an increase in the number of CT scans performed. Non-accidental injury remains uncommon in this patient group. Outcome was excellent for all patients.

Fatal Intramuscular Bleeding Misdiagnosed as Suspected Nonaccidental Injury

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 771-773
Author(s):  
Randall C. Wetzel ◽  
Anthony J. Slater ◽  
George J. Dover
Keyword(s):  
Child Abuse ◽  
Case Report ◽  
Cardiopulmonary Resuscitation ◽  
Female Infant ◽  
Parental Anxiety ◽  
Great Care ◽  
Accidental Injury ◽  
Born Child ◽  
Non Accidental Injury ◽  
Nonaccidental Injury

The syndromes of child abuse or non-accidental injury (NAI) are readily recognized. The frequency of NAI requires that it be considered in any child who has been, or appears to have been, traumatized. Nevertheless, great care must be exercised to avoid the parental anxiety and stress that may result from the mistaken diagnosis of child abuse.1 Many conditions mimic NAI, and even well-described ones may be overlooked due to their present rarity. CASE REPORT This 10-week-old female infant was comatose, hypotensive, with poorly perfused extremities, and had received cardiopulmonary, resuscitation (CPR). She was the first-born child of a 24-year-old Hispanic mother and a 32-year-old Jewish father.

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