Inflicted Traumatic Brain Injury: Making the Diagnosis in the Emergency Department

Inflicted traumatic brain injury (iTBI) is a common cause of morbidity and mortality in young children. Inflicted traumatic brain injury can present with a wide spectrum of symptoms and clinical findings. Children who have milder forms of iTBI and less ominous symptoms, such as vomiting and irritability, may not be recognized until they present later with more serious injury. Although retinal hemorrhages, rib fractures, and subdural hemorrhage are the triad typically associated with iTBI, a minority of patients will have all 3 findings. The importance of recognizing iTBI in a timely manner in the emergency department is vital to protect the child from future and possibly more severe brain injury.