The evaluation of a child for abuse must avoid both false positive and false negative diagnoses. A subdural hematoma can occur in a child for reasons other than abusive head injury.


Conditions that can cause a subdural hematoma in a child:

(1) vaginal delivery (this should clear within a few weeks or months of birth)

(2) accidental head trauma

(3) intracranial arteriovenous malformation or other congenital malformation

(4) meningitis or septicemia

(5) glutaric aciduria

(6) osteogenesis imperfecta

(7) thrombocytopenia, hemophilia, DIC, vitamin K deficiency or other bleeding disorder

(8) brain tumor

(9) vasculitis


A child with one of these findings could also be abused, but the diagnosis would need to be substantiated based on other findings.


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