A Retrospective Study of Cervical Spine MRI Findings in Children with Abusive Head Trauma

Governale, Lance S.; Brink, Farah W.; Pluto, Charles P.; Schunemann, Victoria; Weber, Rachel; Rusin, Jerome; Fischer, Beth; Letson, Megan M.

doi:10.1159/000481511

Cited by 12 publications

(3 citation statements)

References 22 publications

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“…Governale et al (46) found that none of the children with MRI findings of cervical spine injury in their patient cohort had a clinically evident nor a clinically unstable cervical spine injury and, as a result, none required surgical intervention (46). Although the demonstration of spine injuries may not change clinical management, the identification of these abnormalities supports the diagnosis of abuse and may have implications for child protection.…”

Section: Spine Fracturementioning

confidence: 98%

“…The presence of posterior ligamentous complex injury is more common in AHT than in accidental trauma (20,36). Prevertebral edema is also a commonly encountered imaging finding (36,46). Anterior and posterior longitudinal ligament injuries are rarely seen (45,46).…”

Section: Ligamentous Injurymentioning

confidence: 99%

“…Prevertebral edema is also a commonly encountered imaging finding (36,46). Anterior and posterior longitudinal ligament injuries are rarely seen (45,46).…”

Section: Ligamentous Injurymentioning

confidence: 99%

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Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas

et al. 2019

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Infants and children under 2 years of age are at greatest risk for devastating neurologic complications following nonaccidental trauma. While a subdural hematoma (SDH) is the most common finding and is often enough to raise suspicion for abuse, no single injury is pathognomonic for abusive head trauma (AHT). Rather, the combination of imaging and physical findings and the clinical presentation help confirm the diagnosis of AHT. Familiarity with the spectrum of findings and proper identification of the imaging abnormalities is important for the radiologist to facilitate treatment and removal of the patient from the abusive environment. Injury is usually a result of shaking, which includes hyperflexion, hyperextension, and rotational forces, and less commonly impact trauma or a combination of both. Key anatomic features unique to the infant's head, neck, and spine and associated biomechanical forces are responsible for entities such as hypoxic ischemic injury, bridging vein thrombosis, SDH, parenchymal lacerations, and spinal and retinal injuries. Although the association of subpial hemorrhage with AHT has not been investigated, it warrants attention in very young infants who endure accidental or inflicted trauma. A combination of CT of the head and MRI of the brain and cervical spine aids in the accurate diagnosis, appropriate management, and subsequent protection of these patients. ©

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Section: Spine Fracturementioning

confidence: 98%