Almost all are due to abuse but abuse is often not recognised

Papers p 1558

In this issue Jayawant et al report the results of a study of the incidence, causes, and outcome of subdural haemorrhages in infancy in a defined geographical area in England and Wales from 1993 to 1995 (p 1558).1 This subject is important because, as this study confirms, most subdural haemorrhages are due to abuse. The subdural haemorrhage is just one element of the brain injury in infants who have suffered non-accidental head injury (caused either by shaking alone or by shaking and impact).2

Ascertainment seems to have been thorough and the results are likely to be generalisable to the rest of the United Kingdom. The results suggest that a large district general hospital can expect, on average, to see an infant with a subdural haemorrhage every year. Most of these infants needed intensive care and, as in other studies, the outcome was poor. 3 4 Assuming that the results are generalisable, …