Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Case 100 - Non-accidental trauma: neuroimaging
from Section 8 - Pediatrics
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Summary
Imaging description
Head trauma is the leading cause of child abuse fatality and a major factor in long-term morbidity [1, 2]. It is important to image the brain in all suspected cases of inflicted trauma. This is typically performed with a CT head without contrast, for its ability to detect intracranial hemorrhage, cerebral edema, and skull fractures. MRI is occasionally performed to better characterize extra-axial fluid collections, identify parenchymal infarcts or ischemia in the setting of suffocation, and recognize subtle cases of shear injury [3, 4]. Cranial ultrasound does not play a significant role in the initial neuroimaging evaluation of nonaccidental trauma.
Subdural hemorrhage is the most common intracranial manifestation of inflicted trauma [1]. As in adults, acute subdural blood is hyperattenuating on a non-contrast CT, the result of shear forces tearing bridging cortical veins that drain into the dural venous sinuses. Subdural hemorrhage is non-specific for traumatic injury. Close correlation with available clinical history is warranted when differentiating accidental versus non-accidental trauma. Nonaccidental injury produces hemorrhage that is more frequently bilateral and distant from the site of calvarial fracture, due to shear forces rather than direct coup injury [5]. Acute subdural hemorrhage must also be distinguished from the normal falx cerebri and tentorium cerebelli, which are prominent in infants. The latter are symmetrically dense and thickened on non-contrast CT, while hemorrhage thickens these dural reflections in an asymmetric or nodular fashion [6, 7].
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 366 - 370Publisher: Cambridge University PressPrint publication year: 2013