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MR imaging of shaken baby syndrome manifested as chronic subdural hematoma
1Department of Radiology, Hallym University Sacred Heart Hospital, Anyang City, Kyungki-do, Korea. leeyul@www.hallym.or.kr
Insights
Shaken baby syndrome (SBS) can cause severe head injuries like subdural hematoma (SDH). MRI findings in infants with SBS show characteristic signs of chronic SDH, including rebleeding and dural enhancement.
Area of Science:
- Neurology
- Pediatric Radiology
- Forensic Medicine
Background:
- Shaken baby syndrome (SBS) is a severe form of abusive head trauma in infants.
- Subdural hematoma (SDH) is the most frequent neurological injury associated with SBS.
- Accurate diagnosis of SBS relies on recognizing characteristic injury patterns.
Observation:
- This report details MRI findings in three infants diagnosed with SBS.
- The cases involved infants aged two, three, and eight months.
- Specific attention was given to the magnetic resonance imaging (MRI) characteristics of subdural hematomas.
Findings:
- Chronic subdural hematomas (SDH) in SBS cases typically exhibit low signal intensity on T1-weighted MRI sequences.
- High signal intensity on T2-weighted MRI sequences is characteristic of chronic SDH.
- Focal high signal on T1-weighted images suggests rebleeding within the chronic SDH, and contrast-enhanced MRI shows diffuse dural enhancement.
Implications:
- Understanding these MRI findings aids in the diagnosis of SBS.
- Radiological evidence of chronic SDH can support the identification of abusive head trauma.
- This knowledge is crucial for pediatricians, radiologists, and forensic investigators involved in child abuse cases.
Abstract:
Shaken baby syndrome (SBS) is a form of child abuse that can cause significant head injuries, of which subdural hematoma (SDH) is the most common manifestation. We report the MRI findings of chronic SDH in three cases of SBS, involving two-, three- and eight-month-old babies. The SDH signal was mostly low on T1-weighted images and high on T2-weighted images, suggesting chronic SDH. In chronic SDH, a focal high signal on T1-weighted images was also noted, suggesting rebleeding. Contrast-enhanced MRI revealed diffuse dural enhancement.
