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Abusive head trauma Part II: radiological aspects

Tessa Sieswerda-Hoogendoorn1, Stephen Boos, Betty Spivack

  • 1Section Forensic Paediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands. T.Sieswerda@amc.uva.nl

European Journal of Pediatrics
|November 15, 2011
PubMed

Insights

Abusive head trauma (AHT) in children requires advanced imaging like CT and MRI. Diagnosis and management of AHT necessitate a multidisciplinary approach, integrating clinical and psychosocial data.

Area of Science:

  • Pediatric Radiology
  • Child Abuse Forensics

Background:

  • Abusive head trauma (AHT) is a significant cause of pediatric neurotrauma.
  • Radiology is crucial for diagnosing and prognosing AHT in children.

Purpose of the Study:

  • To outline the role of neuroimaging in diagnosing and managing AHT.
  • To provide guidance on appropriate imaging modalities and follow-up strategies for suspected AHT.

Main Methods:

  • Review of current radiological practices for AHT evaluation.
  • Discussion of imaging techniques including CT, MRI with DWI, and skeletal surveys.
  • Exclusion of cranial ultrasonography for AHT diagnosis.

Main Results:

  • CT followed by MRI with DWI is the optimal neuroimaging approach for AHT.
  • A full skeletal survey is recommended to detect associated injuries or bone diseases.
  • No definitive evidence-based protocol exists for AHT follow-up imaging.

Conclusions:

  • Radiological findings alone are insufficient for an AHT diagnosis.
  • A multidisciplinary team assessment integrating clinical and psychosocial information is essential for diagnosis.
  • Immediate communication with clinicians is vital upon suspicion of AHT for protective measures.
Abstract

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