A Retrospective Study of Cervical Spine MRI Findings in Children with Abusive Head Trauma
Lance S Governale1, Farah W Brink, Charles P Pluto
1Division of Pediatric Neurosurgery, University of Florida, Gainesville, FL, USA.
Insights
Cervical spine MRI in abusive head trauma (AHT) cases revealed abnormalities not visible on physical exams. These findings suggest MRI is valuable for diagnosing AHT-related c-spine issues.
Area of Science:
- Pediatric Radiology
- Forensic Pathology
- Child Abuse Pediatrics
Background:
- Abusive head trauma (AHT) is a significant concern in child abuse investigations.
- The association between AHT and cervical spine (c-spine) injuries is increasingly recognized.
- Accurate diagnosis of c-spine injuries in AHT is crucial for patient management and legal proceedings.
Background/Aims:
Increasing attention has been given to the possible association of cervical spine (c-spine) injuries with abusive head trauma (AHT). The aims of this study were to describe c-spine MRI findings in hospitalized AHT patients.
Methods:
This is a retrospective study of children under the age of 5 years with AHT admitted to hospital in 2004-2013. Those with c-spine MRI were identified, and the images were reviewed.
Results:
250 AHT cases were identified, with 34 (14%) undergoing c-spine MRI. Eleven patients (32%) had 25 findings, including hematoma in 2, occiput-C1-C2 edema in 3, prevertebral edema in 6, facet edema in 2, and interspinous and/or muscular edema in 10. No patients had a clinically evident c-spine injury, a clinically unstable c-spine, or required c-spine surgery.
Conclusions:
C-spine MRI may identify abnormalities not apparent upon physical examination and the procedure should therefore be considered in cases of suspected AHT.
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