Review

European Journal of Pediatrics

, Volume 171, Issue 4, pp 617-623

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Educational paper

Abusive Head Trauma Part II: Radiological aspects
  • Tessa Sieswerda-HoogendoornAffiliated withSection Forensic Paediatrics, Department of Forensic Medicine, Netherlands Forensic InstituteDepartment of Radiology, Emma Children’s Hospital–Academic Medical Centre Amsterdam Email author 
  • , Stephen BoosAffiliated withDepartment of Pediatrics, Baystate Children’s Hospital
  • , Betty SpivackAffiliated with
  • , Rob A. C. BiloAffiliated withSection Forensic Paediatrics, Department of Forensic Medicine, Netherlands Forensic Institute
  • , Rick R. van RijnAffiliated withSection Forensic Paediatrics, Department of Forensic Medicine, Netherlands Forensic InstituteDepartment of Radiology, Emma Children’s Hospital–Academic Medical Centre Amsterdam

Abstract

Abusive head trauma (AHT) is a relatively common cause of neurotrauma in young children. Radiology plays an important role in establishing a diagnosis and assessing a prognosis. Computed tomography (CT), followed by magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI), is the best tool for neuroimaging. There is no evidence-based approach for the follow-up of AHT; both repeat CT and MRI are currently used but literature is not conclusive. A full skeletal survey according to international guidelines should always be performed to obtain information on possible underlying bone diseases or injuries suspicious for child abuse. Cranial ultrasonography is not indicated as a diagnostic modality for the evaluation of AHT. If there is a suspicion of AHT, this should be communicated with the clinicians immediately in order to arrange protective measures as long as AHT is part of the differential diagnosis. Conclusion: The final diagnosis of AHT can never be based on radiological findings only; this should always be made in a multidisciplinary team assessment where all clinical and psychosocial information is combined and judged by a group of experts in the field.

Keywords

Abusive head trauma Radiology Child abuse Head injury Closed Haematoma Subdural