RCH Clinical Practice Guideline Head injury

Forensic investigation of suspected abusive head trauma

• Consider radiological imaging (MRI and/or CT brain scan) of the brains of infants and young children who might have been shaken.
• MRI whole spine
• Investigate as for fracture
• Consult with an ophthalmologist (and arrange for examination by the ophthalmologist)
• Investigate as for bruising when intracranial haemorrhage exists
• Urine metabolic screen and consider serum organic acids, other metabolic tests and consultation with a genetic/metabolic specialist
• Admission to ICU should be considered  whenever altered conscious state has occurred after suspected shaking because of the high risk of further neurological deterioration caused by progressive brain swelling