Caffey 3

Significance of the History in the Diagnosis of Traumatic Injury to Children

Citation:

Caffey J: Significance of the history in the diagnosis of traumatic injury to children. Journal of Pediatrics 67(5):1008-1014, November 1965.

Notes:

This was Dr. Caffey's address when he accepted the Howland Award.
Parents are usually totally ignorant of the traumatic episode if the child is injured when not in their care.
Without a history, physicians may suspect hemorrhagic disease, collagen disease, leukemia and lymphoblastoma, neoplasms, low-grade inflammations, scurvy, infantile cortical hyperostosis, brain tumor, meningoencephalitis.
The failure of the parents to give a history of injury is not necessarily proof that the parent has injured the child.
"The mere accusation of being a child-beater is no proof at all that the individual parent is guilty, but the mere charge smears the accused wrongfully, sometimes permanently, before he is tried." (p. 1013)
Children can have developed severe subdural hematomas after short falls.