Abstract

This issue of the Southern Medical Journal introduces an important pediatric research article concerning the presence of occult brain injuries in clinically asymptomatic young children of less than twenty months.¹ The article examines the presence of brain injuries of both abusive and accidental victims as seen with neuroimaging and notes a higher incidence than expected of brain injuries of asymptomatic children. Although an association between closed head injury and child abuse is known, questions arise as to whether neuroimaging in an asymptomatic young child should be obtained. There are no current guidelines for physicians to screen asymptomatic children for occult brain injuries of accidental trauma, though this study might be useful for physicians in deciding to screen this population in these circumstances. The conclusion of the article stresses a higher rate than expected of brain injuries in the asymptomatic child of accidental trauma. The article also, once again, highlights the presence of brain injuries in the asymptomatic abused child. Given the importance of confirming child abuse and making safety recommendations, we believe the findings of such a high incidence of occult brain injuries in this study should influence the guidelines for neuroimaging in this population.