If the history and the physical and radiological findings are suggestive of this diagnosis, the patient should be admitted to the hospital for treatment. A thorough, unbiased evaluation is essential. If abuse is suspected, the law in the U.S. requires that the appropriate child-welfare and law enforcement agencies be notified. The medical record has great legal importance, and careful documentation will later benefit the physician, who may be subpoenaed to testify in court. The social work team has to take the lead in planning the strategy for management, but they depend on the full cooperation of medical and nursing personnel involved and the police.
Direct impact is more likely to result in cerebral contusion.
12 Cerebral contusion occurs either with or without external evidence of trauma. Shaking of the head can tear superficial veins over the brain and cause acute subdural hematoma. 1 Acute subdural hematoma in Case 1 was a result of an inflicted injury, and it appeared identical to hematoma secondary to accidental injury, and showed a mass effect. After evacuation, the underlying brain infarction persisted in the right cerebral hemisphere. This condition was similar to that described by Duhaime et al., who mentioned that subdural hematomas resulting from inflicted injury appear identical to those secondary to accidental injury, and clearly have mass effect.