Abusive head trauma in infants and young children

Patients require ongoing close medical monitoring after discharge from hospital. Some patients who survive require placement in a rehabilitation facility before discharge home.

Seizure medication must be monitored by neurology service, with appropriate drug levels taken at preordained intervals. Nutrition must be followed, especially if placement of a feeding tube was required. Ophthalmological injury may require ongoing intervention such as vitrectomy for dense vitreous haemorrhage or treatment of glaucoma related to increased intraocular pressure. Orthopaedic injuries may require serial casting or surgical correction.

Children with developmental delay will benefit from early and aggressive physical and occupational therapy, and may require ongoing work with developmental specialists as they enter the school setting. Specialist input by ophthalmology and audiological physicians may also be required, as well as input from mental health teams for patients and families as the legal processes surrounding the diagnosis of abuse move forward.