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Neuroimaging of nonaccidental head trauma: pitfalls and controversies

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Abstract

Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma.

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Author information

Authors and Affiliations

  1. Department of Medicine, University of Missouri-Kansas School of Medicine, Kansas City, MO, USA

    Sujan Fernando

  2. Department of Radiology, The University of Kansas Medical Center, Kansas City, MO, USA

    Ruby E. Obaldo

  3. Department of Emergency Medicine, The University of Missouri-Kansas City, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA

    Irene R. Walsh

  4. Department of Radiology, The University of Missouri-Kansas City, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA

    Lisa H. Lowe

  5. 7306 W. 57th St., Mission, KS, 66202, USA

    Sujan Fernando

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  1. Sujan Fernando
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Correspondence to Sujan Fernando.

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Fernando, S., Obaldo, R.E., Walsh, I.R. et al. Neuroimaging of nonaccidental head trauma: pitfalls and controversies. Pediatr Radiol 38, 827–838 (2008). https://doi.org/10.1007/s00247-007-0729-1

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  • DOI: https://doi.org/10.1007/s00247-007-0729-1

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