Nonaccidental @entity542 in XXXX .

@entity1 @entity137 @entity2657 @entity174 @entity510 @entity548 @entity3702 @entity4 @entity542 @entity519 @entity5861 @entity204 @entity130
BACKGROUND: Nonaccidental @entity542 in @entity1 is the leading cause of @entity1 @entity204 from injury. RESULTS AND DISCUSSION: Clinical features that suggest inflicted @entity542 include the triad of the so-called @entity3702 , consisting of @entity5861 , subdural, and/or @entity510 in an @entity1 with little signs of external @entity130 . Studies have shown that, in general, the average short fall in the home is extremely unlikely to produce either subdural or @entity5861 , although focal injuries such as @entity174 and @entity548 may be seen. Acceleration/deceleration, especially of the rotational type, is believed to be the most probable mechanism of injury in cases of nonaccidental @entity542 . Damage to the cervicomedullary junction and the respiratory centers, with subsequent @entity519 and @entity4 , has also been implicated. After the initial @entity130 and @entity548 , loss of cerebral autoregulation, breakdown of the blood-brain barrier, and disruption of ionic homeostasis occur, leading to @entity2657 and @entity137 . Cellular damage can involve large volumes of tissue, without respecting vascular territories. CONCLUSION: Overall, a satisfactory biomechanical model is lacking, and the criminal nature of @entity130 makes it difficult to perform systematic, controlled studies. Unfortunately, outcomes are poor, and the rate of repeated abusive episodes is high. Future research should focus on the development of a satisfactory research model and on prevention strategies.
