Skip to main content
Top
Published in: Pediatric Radiology 5/2016

01-05-2016 | Review

Neuroimaging differential diagnoses to abusive head trauma

Authors: Nadine Girard, Hervé Brunel, Philippe Dory-Lautrec, Brigitte Chabrol

Published in: Pediatric Radiology | Issue 5/2016

Login to get access

Abstract

Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury.
Literature
1.
go back to reference Duhaime AC, Gennarelli TA, Thibault LE et al (1987) The shaken baby syndrome. A clinical, pathological, and biomechanical study. J Neurosurg 66:409–415CrossRefPubMed Duhaime AC, Gennarelli TA, Thibault LE et al (1987) The shaken baby syndrome. A clinical, pathological, and biomechanical study. J Neurosurg 66:409–415CrossRefPubMed
2.
go back to reference Lopes NR, Eisenstein E, Williams LC (2013) Abusive head trauma in children: a literature review. J Pediatr 89:426–433CrossRef Lopes NR, Eisenstein E, Williams LC (2013) Abusive head trauma in children: a literature review. J Pediatr 89:426–433CrossRef
3.
4.
go back to reference Laurent-Vannier A, Nathanson M, Quiriau F et al (2011) A public hearing: ‘Shaken baby syndrome: guidelines on establishing a robust diagnosis and the procedures to be adopted by healthcare and social services staff’. Guidelines issued by the Hearing Commission. Ann Phys Rehabil Med 54:600–625CrossRefPubMed Laurent-Vannier A, Nathanson M, Quiriau F et al (2011) A public hearing: ‘Shaken baby syndrome: guidelines on establishing a robust diagnosis and the procedures to be adopted by healthcare and social services staff’. Guidelines issued by the Hearing Commission. Ann Phys Rehabil Med 54:600–625CrossRefPubMed
5.
go back to reference Vinchon M, Defoort-Dhellemmes S, Desurmont M et al (2005) Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg 102:380–384PubMed Vinchon M, Defoort-Dhellemmes S, Desurmont M et al (2005) Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg 102:380–384PubMed
6.
go back to reference Tun K, Choudhary AK, Methratta S et al (2013) Radiological features of nonaccidental injury. J Radiol Nurs 32:3–9CrossRef Tun K, Choudhary AK, Methratta S et al (2013) Radiological features of nonaccidental injury. J Radiol Nurs 32:3–9CrossRef
7.
go back to reference Zimmerman RA, Bilaniuk LT, Bruce D et al (1978) Interhemispheric acute subdural hematoma: a computed tomographic manifestation of child abuse by shaking. Neuroradiology 16:39–40CrossRefPubMed Zimmerman RA, Bilaniuk LT, Bruce D et al (1978) Interhemispheric acute subdural hematoma: a computed tomographic manifestation of child abuse by shaking. Neuroradiology 16:39–40CrossRefPubMed
8.
go back to reference Barlow KM, Gibson RJ, McPhillips M et al (1999) Magnetic resonance imaging in acute non-accidental head injury. Acta Paediatr 88:734–740CrossRefPubMed Barlow KM, Gibson RJ, McPhillips M et al (1999) Magnetic resonance imaging in acute non-accidental head injury. Acta Paediatr 88:734–740CrossRefPubMed
10.
go back to reference Duhaime AC, Christian C (1999) Nonaccidental trauma. In: Choux M, Di Rocco C, Hockley A, Walker M (eds) Pediatric neurosurgery. Churchill Livingstone, London, pp 373–379 Duhaime AC, Christian C (1999) Nonaccidental trauma. In: Choux M, Di Rocco C, Hockley A, Walker M (eds) Pediatric neurosurgery. Churchill Livingstone, London, pp 373–379
11.
go back to reference Piteau SJ, Ward MG, Barrowman NJ et al (2012) Clinical and radiographic characteristics associated with abusive and nonabusive head trauma: a systematic review. Pediatrics 130:315–323CrossRefPubMed Piteau SJ, Ward MG, Barrowman NJ et al (2012) Clinical and radiographic characteristics associated with abusive and nonabusive head trauma: a systematic review. Pediatrics 130:315–323CrossRefPubMed
12.
go back to reference Kemp AM (2011) Abusive head trauma: recognition and the essential investigation. Arch Dis Child Educ Pract Ed 96:202–208CrossRefPubMed Kemp AM (2011) Abusive head trauma: recognition and the essential investigation. Arch Dis Child Educ Pract Ed 96:202–208CrossRefPubMed
13.
go back to reference Meservy CJ, Towbin R, McLaurin RL et al (1987) Radiographic characteristics of skull fractures resulting from child abuse. AJR Am J Roentgenol 149:173–175CrossRefPubMed Meservy CJ, Towbin R, McLaurin RL et al (1987) Radiographic characteristics of skull fractures resulting from child abuse. AJR Am J Roentgenol 149:173–175CrossRefPubMed
15.
go back to reference Choudhary AK, Jha B, Boal DK et al (2010) Occipital sutures and its variations: the value of 3D-CT and how to differentiate it from fractures using 3D-CT? Surg Radiol Anat 32:807–816CrossRefPubMed Choudhary AK, Jha B, Boal DK et al (2010) Occipital sutures and its variations: the value of 3D-CT and how to differentiate it from fractures using 3D-CT? Surg Radiol Anat 32:807–816CrossRefPubMed
17.
go back to reference Gean AD (1995) Pediatric trauma. In: Gean AD (ed) Imaging of head trauma. Raven, New York, pp 367–426 Gean AD (1995) Pediatric trauma. In: Gean AD (ed) Imaging of head trauma. Raven, New York, pp 367–426
18.
go back to reference Geddes JF, Tasker RC, Hackshaw AK et al (2003) Dural haemorrhage in non-traumatic infant deaths: does it explain the bleeding in ‘shaken baby syndrome’? Neuropathol Appl Neurobiol 29:14–22CrossRefPubMed Geddes JF, Tasker RC, Hackshaw AK et al (2003) Dural haemorrhage in non-traumatic infant deaths: does it explain the bleeding in ‘shaken baby syndrome’? Neuropathol Appl Neurobiol 29:14–22CrossRefPubMed
19.
go back to reference Zimmerman RA, Bilaniuk LT, Farina L (2007) Non-accidental brain trauma in infants: diffusion imaging, contributions to understanding the injury process. J Neuroradiol 34:109–114CrossRefPubMed Zimmerman RA, Bilaniuk LT, Farina L (2007) Non-accidental brain trauma in infants: diffusion imaging, contributions to understanding the injury process. J Neuroradiol 34:109–114CrossRefPubMed
20.
go back to reference Reece RM, Sege R (2000) Childhood head injuries: accidental or inflicted? Arch Pediatr Adolesc Med 154:11–15PubMed Reece RM, Sege R (2000) Childhood head injuries: accidental or inflicted? Arch Pediatr Adolesc Med 154:11–15PubMed
21.
go back to reference Hymel KP, Rumack CM, Hay TC et al (1997) Comparison of intracranial computed tomographic (CT) findings in pediatric abusive and accidental head trauma. Pediatr Radiol 27:743–747CrossRefPubMed Hymel KP, Rumack CM, Hay TC et al (1997) Comparison of intracranial computed tomographic (CT) findings in pediatric abusive and accidental head trauma. Pediatr Radiol 27:743–747CrossRefPubMed
22.
go back to reference Cohen RA, Kaufman RA, Myers PA et al (1986) Cranial computed tomography in the abused child with head injury. AJR Am J Roentgenol 146:97–102CrossRefPubMed Cohen RA, Kaufman RA, Myers PA et al (1986) Cranial computed tomography in the abused child with head injury. AJR Am J Roentgenol 146:97–102CrossRefPubMed
23.
go back to reference Ewing-Cobbs L, Prasad M, Kramer L et al (2000) Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury. Childs Nerv Syst 16:25–33CrossRefPubMed Ewing-Cobbs L, Prasad M, Kramer L et al (2000) Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury. Childs Nerv Syst 16:25–33CrossRefPubMed
24.
go back to reference Gabaeff SC (2013) Investigating the possibility and probability of perinatal subdural hematoma progressing to chronic subdural hematoma, with and without complications, in neonates, and its potential relationship to the misdiagnosis of abusive head trauma. Leg Med (Tokyo) 15:177–192CrossRef Gabaeff SC (2013) Investigating the possibility and probability of perinatal subdural hematoma progressing to chronic subdural hematoma, with and without complications, in neonates, and its potential relationship to the misdiagnosis of abusive head trauma. Leg Med (Tokyo) 15:177–192CrossRef
25.
go back to reference Whitby EH, Griffiths PD, Rutter S et al (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846–851CrossRefPubMed Whitby EH, Griffiths PD, Rutter S et al (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846–851CrossRefPubMed
26.
go back to reference Rooks VJ, Eaton JP, Ruess L et al (2008) Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants. AJNR Am J Neuroradiol 29:1082–1089CrossRefPubMed Rooks VJ, Eaton JP, Ruess L et al (2008) Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants. AJNR Am J Neuroradiol 29:1082–1089CrossRefPubMed
27.
go back to reference Tung GA, Kumar M, Richardson RC et al (2006) Comparison of accidental and nonaccidental traumatic head injury in children on noncontrast computed tomography. Pediatrics 118:626–633CrossRefPubMed Tung GA, Kumar M, Richardson RC et al (2006) Comparison of accidental and nonaccidental traumatic head injury in children on noncontrast computed tomography. Pediatrics 118:626–633CrossRefPubMed
28.
go back to reference Vinchon M, Noule N, Tchofo PJ et al (2004) Imaging of head injuries in infants: temporal correlates and forensic implications for the diagnosis of child abuse. J Neurosurg 101:44–52PubMed Vinchon M, Noule N, Tchofo PJ et al (2004) Imaging of head injuries in infants: temporal correlates and forensic implications for the diagnosis of child abuse. J Neurosurg 101:44–52PubMed
29.
go back to reference Adamsbaum C, Rambaud C (2012) Abusive head trauma: don’t overlook bridging vein thrombosis. Pediatr Radiol 42:1298–1300CrossRefPubMed Adamsbaum C, Rambaud C (2012) Abusive head trauma: don’t overlook bridging vein thrombosis. Pediatr Radiol 42:1298–1300CrossRefPubMed
30.
go back to reference Gomori JM, Grossman RI, Hackney DB et al (1988) Variable appearances of subacute intracranial hematomas on high-field spin-echo MR. AJR Am J Roentgenol 150:171–178CrossRefPubMed Gomori JM, Grossman RI, Hackney DB et al (1988) Variable appearances of subacute intracranial hematomas on high-field spin-echo MR. AJR Am J Roentgenol 150:171–178CrossRefPubMed
31.
go back to reference Vezina G (2009) Assessment of the nature and age of subdural collections in nonaccidental head injury with CT and MRI. Pediatr Radiol 39:586–590CrossRefPubMed Vezina G (2009) Assessment of the nature and age of subdural collections in nonaccidental head injury with CT and MRI. Pediatr Radiol 39:586–590CrossRefPubMed
32.
go back to reference Adamsbaum C, Morel B, Ducot B et al (2014) Dating the abusive head trauma episode and perpetrator statements: key points for imaging. Pediatr Radiol 44:S578–588CrossRefPubMed Adamsbaum C, Morel B, Ducot B et al (2014) Dating the abusive head trauma episode and perpetrator statements: key points for imaging. Pediatr Radiol 44:S578–588CrossRefPubMed
33.
34.
go back to reference Gilles EE, Nelson MD Jr (1998) Cerebral complications of nonaccidental head injury in childhood. Pediatr Neurol 19:119–128CrossRefPubMed Gilles EE, Nelson MD Jr (1998) Cerebral complications of nonaccidental head injury in childhood. Pediatr Neurol 19:119–128CrossRefPubMed
35.
go back to reference Biousse V, Suh DY, Newman NJ et al (2002) Diffusion-weighted magnetic resonance imaging in shaken baby syndrome. Am J Ophthalmol 133:249–255CrossRefPubMed Biousse V, Suh DY, Newman NJ et al (2002) Diffusion-weighted magnetic resonance imaging in shaken baby syndrome. Am J Ophthalmol 133:249–255CrossRefPubMed
36.
37.
go back to reference Ment LR, Duncan CC, Geehr R (1981) Benign enlargement of the subarachnoid spaces in the infant. J Neurosurg 54:504–508CrossRefPubMed Ment LR, Duncan CC, Geehr R (1981) Benign enlargement of the subarachnoid spaces in the infant. J Neurosurg 54:504–508CrossRefPubMed
38.
go back to reference Raul JS, Roth S, Ludes B et al (2008) Influence of the benign enlargement of the subarachnoid space on the bridging veins strain during a shaking event: a finite element study. Int J Legal Med 122:337–340CrossRefPubMed Raul JS, Roth S, Ludes B et al (2008) Influence of the benign enlargement of the subarachnoid space on the bridging veins strain during a shaking event: a finite element study. Int J Legal Med 122:337–340CrossRefPubMed
39.
go back to reference Vinchon M, Delestret I, DeFoort-Dhellemmes S et al (2010) Subdural hematoma in infants: can it occur spontaneously? Data from a prospective series and critical review of the literature. Childs Nerv Syst 26:1195–1205CrossRefPubMed Vinchon M, Delestret I, DeFoort-Dhellemmes S et al (2010) Subdural hematoma in infants: can it occur spontaneously? Data from a prospective series and critical review of the literature. Childs Nerv Syst 26:1195–1205CrossRefPubMed
40.
go back to reference Adamsbaum C, Mejean N, Merzoug V et al (2010) How to explore and report children with suspected non-accidental trauma. Pediatr Radiol 40:932–938CrossRefPubMed Adamsbaum C, Mejean N, Merzoug V et al (2010) How to explore and report children with suspected non-accidental trauma. Pediatr Radiol 40:932–938CrossRefPubMed
41.
go back to reference Oberbauer RW (1999) Intracranial and intraspinal cysts. In: Choux M, Di Rocco C, Hockley A, Walker M (eds) Pediatric neurosurgery. Churchill Livingstone, London, pp 137–149 Oberbauer RW (1999) Intracranial and intraspinal cysts. In: Choux M, Di Rocco C, Hockley A, Walker M (eds) Pediatric neurosurgery. Churchill Livingstone, London, pp 137–149
42.
go back to reference Girard N, Zimmerman RA (1997) Infectious and inflammatory diseases of the brain and spinal cord. In: Zimmerman RA, Gibby WA, Carmody RF (eds) Neuroimaging: clinical and physical principles. Spiringer-Verlag, New York, pp 909–950 Girard N, Zimmerman RA (1997) Infectious and inflammatory diseases of the brain and spinal cord. In: Zimmerman RA, Gibby WA, Carmody RF (eds) Neuroimaging: clinical and physical principles. Spiringer-Verlag, New York, pp 909–950
43.
go back to reference Zimmerman RA, Wong AM, Girard N (2004) Imaging of intracranial infections. In: Scheld WM, Whitley RJ, Marra CM (eds) Infections of the central nervous system. Lippincott Williams & Wilkins, Philadelphia, pp 31–55 Zimmerman RA, Wong AM, Girard N (2004) Imaging of intracranial infections. In: Scheld WM, Whitley RJ, Marra CM (eds) Infections of the central nervous system. Lippincott Williams & Wilkins, Philadelphia, pp 31–55
44.
go back to reference Jackson J, Carpenter S, Anderst J (2012) Challenges in the evaluation for possible abuse: presentations of congenital bleeding disorders in childhood. Child Abuse Negl 36:127–134CrossRefPubMed Jackson J, Carpenter S, Anderst J (2012) Challenges in the evaluation for possible abuse: presentations of congenital bleeding disorders in childhood. Child Abuse Negl 36:127–134CrossRefPubMed
46.
go back to reference Hoffmann GF, Kolker S (2012) Cerebral organic acid disorders and other disorders of lysine catabolism. In: Saudubray JM, van den Berghe G, Walter JH (eds) Inborn metabolic diseases: diagnosis and treatment. Springer, Berlin Heidelberg, pp 333–346CrossRef Hoffmann GF, Kolker S (2012) Cerebral organic acid disorders and other disorders of lysine catabolism. In: Saudubray JM, van den Berghe G, Walter JH (eds) Inborn metabolic diseases: diagnosis and treatment. Springer, Berlin Heidelberg, pp 333–346CrossRef
48.
go back to reference Bierings M, Clayton P, Houwen RHJ (2012) Disorders in the transport of copper, iron, magnesium, manganese, selenium and zinc. In: Saudubray JM, van den Berghe G, Walter JH (eds) Inborn metabolic diseases: diagnosis and treatment. Springer, Berlin Heidelberg, pp 535–549CrossRef Bierings M, Clayton P, Houwen RHJ (2012) Disorders in the transport of copper, iron, magnesium, manganese, selenium and zinc. In: Saudubray JM, van den Berghe G, Walter JH (eds) Inborn metabolic diseases: diagnosis and treatment. Springer, Berlin Heidelberg, pp 535–549CrossRef
49.
go back to reference Hill SC, Dwyer AJ, Kaler SG (2012) Cervical spine anomalies in Menkes disease: a radiologic finding potentially confused with child abuse. Pediatr Radiol 42:1301–1304CrossRefPubMedPubMedCentral Hill SC, Dwyer AJ, Kaler SG (2012) Cervical spine anomalies in Menkes disease: a radiologic finding potentially confused with child abuse. Pediatr Radiol 42:1301–1304CrossRefPubMedPubMedCentral
Metadata
Title
Neuroimaging differential diagnoses to abusive head trauma
Authors
Nadine Girard
Hervé Brunel
Philippe Dory-Lautrec
Brigitte Chabrol
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 5/2016
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-015-3509-3

Other articles of this Issue 5/2016

Pediatric Radiology 5/2016 Go to the issue