Neuroimaging of abusive head trauma

Gary Hedlund; Lori Frasier
December 2009
Forensic Science, Medicine & Pathology;Dec2009, Vol. 5 Issue 4, p280
Academic Journal
Abstract  The diagnostic process for evaluating suspected abusive head trauma in infants and children has evolved with technological advances in neuroimaging. Since Caffey first described a series of children with chronic subdural hematomas and multiple long bone fractures, radiologists have played an important role, along with pediatricians and pathologists, in evaluating abused children. Neuroimaging modalities include ultrasound, CT scans, and MRI technology. Each has distinct clinical applications, as well as practical uses in the clinical diagnostic process of AHT. Importantly, neuroimaging assists in the process of differential diagnosis of other conditions which may mimic AHT. Collaboration between neuroradiologists, clinicians, and pathologists remains critical to making the appropriate diagnosis. Careful history, physical examination, and investigation by legal authorities form the components that result in accurate assessment of any case. This paper reviews pertinent neuroimaging modalities currently utilized in the diagnosis of AHT, describing clinical indications and a collaborative approach to this process.


Related Articles

  • Diagnostic guidelines in abusive head trauma: key recommendations of a French public hearing. Laurent-Vannier, Anne // Pediatric Radiology;Dec2014 Supplement, Vol. 44, p654 

    The article discusses recommendations from a French public hearing regarding the diagnostic guidelines in abusive head trauma. Topics discussed include the importance of accurate diagnosis of abusive head trauma due to underestimated incidence, the mechanism of the lesions, and protecting the...

  • Dating the abusive head trauma episode and perpetrator statements: key points for imaging. Adamsbaum, Catherine; Morel, Baptiste; Ducot, Béatrice; Antoni, Guillemette; Rey-Salmon, Caroline // Pediatric Radiology;Dec2014 Supplement, Vol. 44, p578 

    Shaken baby syndrome/abusive head trauma is a leading cause of morbidity and mortality in infants. The presence of a diffuse subdural hematoma without evidence of accident is a key diagnostic clue. The hematoma is typically attributed to rupture of the cerebral bridging veins due to violent...

  • Isolated cerebral cortical tears in children: aetiology, characterisation and differentiation from non-accidental head injury. Au-Yong, I. T. H.; Wardle, S. P.; McConachie, N. S.; Jaspan, T. // British Journal of Radiology;Sep2009, Vol. 82 Issue 981, p735 

    A wide spectrum of intracranial injuries has been described as complicating difficult birth, particularly following instrumental delivery. We describe five children in whom isolated cortical tears were observed on MRI. Four cases were characterised by a difficult instrumental delivery. None of...

  • Subdural Hematoma in Infants Without Accidental or Nonaccidental Injury: Benign External Hydrocephalus, a Risk Factor. Ghosh, Partha S.; Ghosh, Debabrata // Clinical Pediatrics;Oct2011, Vol. 50 Issue 10, p897 

    Benign external hydrocephalus (BEH) is considered a self-limiting condition in infants. Subdural hematoma (SDH) in infants without a history of trauma indicates nonaccidental injury (NAI). The authors studied whether SDH can complicate BEH without apparent trauma. Out of 45 children younger than...

  • Diffuse Mona! Injury: CT Findings and Clinical Profiles in Six Consecutive Cases. Moschnegootz, S.; Ushakov, A.; Gatin, D.; Shalyakin, K.; Rokhlenko, O. // Neuroradiology Journal;Jun2010, Vol. 23 Issue 3, p296 

    Diffuse axonal injury is a relatively rare type of brain trauma when prolonged coma with generally poor clinical outcome is often associated with negative neuroimaging findings. Although magnetic resonance imaging is the method of choice for evaluation of diffuse axonal injury, computed...

  • Diffusion-weighted MRI in shaken baby syndrome. Yu-Leung Chan; Chu, Winnie C. W.; Wong, Gary W. K.; Yeung, David K. W. // Pediatric Radiology;Aug2003, Vol. 33 Issue 8, p574 

    We present the characteristic CT and MRI findings of a 2-month-old girl with shaken baby syndrome. Diffusion-weighted MR imaging performed 8 days after the insult established the presence of injury to the white matter in the corpus callosum and subcortical white matter in the...

  • If There Is No Trauma History, What's Happened? Yaylacı, Serpil; Serinken, Mustafa // Journal of Academic Emergency Medicine Case Reports / Akademik A;Dec2014, Vol. 5 Issue 12, p272 

    Introduction: Shaken baby syndrome (SBS) is probably an underestimated diagnosis. It is the leading cause of death from child abuse. Crying is thought to contribute to the act of shaking. Case Report: A4-month-old girl presented to the emergency room with convulsions. She was unconscious with...

  • Salmonella-Infected Chronic Subdural Hematoma. Aslan, Adem; Eser, Olcay; Cosar, Murat; Albayrak, Ramazan // Turkish Journal of Medical Sciences;2009, Vol. 39 Issue 1, p139 

    We present herein a case in which salmonella infected a pre-existing chronic subdural hematoma. A one-year-old male infant was admitted to our hospital with complaints of loss of consciousness, seizure, and left hemiparesis. Irrigation and drainage through two burr-holes were performed to the...

  • The CHALICE rule: ready for prime time? Forsyth, R. // Archives of Disease in Childhood;Nov2006, Vol. 91 Issue 11, p877 

    The article comments on the paper written by J. Dunning and colleagues which focuses on the study developing a rule for selection of high risk children with head injury for computed tomography scanning. The author believes that CHALICE, which means Children's Head Injury Algorithm for the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics