Intracranial injuries where child maltreatment should be suspected

• child maltreatment should be suspected if a child has an intracranial injury in the absence of major confirmed accidental trauma or known medical cause, in one or more of the following circumstances:
  • the explanation is absent or unsuitable
  • the child is aged under 3 years
  • there are also: retinal haemorrhages or rib or long bone fractures or other associated inflicted injuries
  • there are multiple subdural haemorrhages with or without subarachnoid haemorrhage with or without hypoxic ischaemic damage (damage due to lack of blood and oxygen supply) to the brain.
• for the purposes of this guideline, NICE state that to suspect child maltreatment means a serious level of concern about the possibility of child maltreatment but is not proof of it

Reference:

• 1. NICE (July 2009). When to suspect child maltreatment