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First, do no harm
  1. M Irani
  1. Children’s Services, Upton Hospital, Windsor, Ascot and Maidenhead PCT, Slough SL1 2BJ, UK;

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The article by Dr Datta and colleagues1 makes interesting reading. The importance of optimal neuroimaging and accurate interpretation of scans is correctly emphasised. Their first recommendation about neuroimaging in all suspected cases of non-accidental head injury (NAHI) is welcome and the point about MRI as a second line investigation contributing to prognostication in these cases has some evidence base. However, I have reservations about the evidence available to support their second and third recommendations.

The recommendation for a head CT scan to be performed as part of “skeletal survey” for children under 6 months of age where physical abuse …

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