{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:45:27Z","timestamp":1777527927867,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Pediatr (Phila)"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To establish whether infants with macrocephaly and non-acute subdural hematomas (SDHs) had missed opportunities for measuring fronto-occipital circumference (FOC) and obtaining neuroimaging prior to diagnosis. Macrocephaly due to SDH in infancy is initially detected by FOC measurements and\/or neuroimaging, as neurologic symptoms may be subtle or missed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective chart review of infants with macrocephaly and non-acute SDHs referred to child abuse pediatricians for suspected abusive head trauma (AHT) over an 8-year period. A study sample of 35 infants met inclusion criteria and had complete prior medical records which were reviewed for missed opportunities for earlier SDH diagnosis. Four types of missed opportunities were identified: not initiating a workup for nonaccidental trauma (NAT) with a history or exam finding of a sentinel injury, not obtaining FOC when presenting with nonspecific neurologic symptoms, no neuroimaging for macrocephalic infants, and incomplete or delayed workup for macrocephaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Most (91%) infants had missed opportunities for earlier diagnosis of macrocephaly and\/or SDH. The most common missed opportunity was no neuroimaging when macrocephalic (N = 28; 54%). Other missed opportunities included not obtaining FOC on a symptomatic infant (N = 10), macrocephaly with incomplete or delayed workup (N = 9), and no NAT workup with a sentinel injury (N = 5). Most of these 35 infants (77%) were diagnosed with concerns for abuse and 43% required surgery upon diagnosis with SDH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Measuring and reviewing FOC, especially in infants with nonspecific neurologic symptoms or infants with sentinel injuries, may facilitate earlier assessment for AHT. An earlier diagnosis of AHT will assist in developing appropriate safety and treatment interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00099228251397058","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T08:07:28Z","timestamp":1765181248000},"page":"393-402","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prior Head Circumference Measurements in Infants With Older Subdural Hematomas: Did We Miss It?"],"prefix":"10.1177","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0282-0096","authenticated-orcid":false,"given":"Maryann","family":"Alvarez Griffis","sequence":"first","affiliation":[{"name":"CARE Team, Driscoll Children\u2019s Hospital, Corpus Christi, TX, USA"},{"name":"University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-1512","authenticated-orcid":false,"given":"Nancy D.","family":"Kellogg","sequence":"additional","affiliation":[{"name":"University of Texas Health San Antonio, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9049-9719","authenticated-orcid":false,"given":"Wouter","family":"Koek","sequence":"additional","affiliation":[{"name":"University of Texas Health San Antonio, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.5.621"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199806183382507"},{"key":"e_1_3_2_4_2","volume-title":"Pediatric Abusive Head Trauma: Recommended Definitions for Public Health Surveillance and Research","author":"Parks S","year":"2012","unstructured":"Parks S, Annest J, Hill A, Karch D. Pediatric Abusive Head Trauma: Recommended Definitions for Public Health Surveillance and Research. Atlanta, GA: Centers for Disease Control and Prevention; 2012."},{"key":"e_1_3_2_5_2","unstructured":"US Department of Health and Human Services Administration on Children Youth Families Children\u2019s Bureau. Child maltreatment. 2013. Published 2015. Accessed November 7 2025. http:\/\/www.acf.hhs.gov\/programs\/cb\/research-data-technology\/statistics-research\/child-maltreatment."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3756"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-022-05780-5"},{"key":"e_1_3_2_8_2","volume-title":"StatPearls","author":"Joyce T","year":"2023","unstructured":"Joyce T, Gossman W, Huecker MR eds. Pediatric abusive head trauma. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023:1-32."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/9781610020473-part06-ch169"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.7.621"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511862366.027"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3588"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0009922811406435"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-020-04848-1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.7.PEDS17317"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2021.04.004"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003076"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18693"},{"key":"e_1_3_2_19_2","unstructured":"Preventive care\/periodicity schedule. Published 2017. Accessed November 7 2025. https:\/\/www.aap.org\/periodicityschedule."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-6393-3.00039-7"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2780"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-020-04915-7"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2010]"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-0883"},{"key":"e_1_3_2_25_2","volume-title":"Child Abuse: Medical Diagnosis and Management","author":"Petska HW","year":"2020","unstructured":"Petska HW, Sheets LK. Sentinel injuries. In: Laskey A, Sirotnak A, eds. Child Abuse: Medical Diagnosis and Management. Itasca, IL: American Academy of Pediatrics; 2020:3-15."},{"key":"e_1_3_2_26_2","unstructured":"American College of Radiology. ACR appropriateness criteria\u00ae suspected physical abuse\u2013child. Revised 2016. Accessed September 23 2025. https:\/\/acsearch.acr.org\/docs\/69443\/narrative\/."},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.794069"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2018.10.018"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/00099228231182780"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0203"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0558"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.176.2.1760289"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/car.2630"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2020.104488"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2022.110652"}],"container-title":["Clinical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00099228251397058","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00099228251397058","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00099228251397058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:34:35Z","timestamp":1777394075000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00099228251397058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/00099228251397058"],"URL":"https:\/\/doi.org\/10.1177\/00099228251397058","relation":{},"ISSN":["0009-9228","1938-2707"],"issn-type":[{"value":"0009-9228","type":"print"},{"value":"1938-2707","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]}}}