Abusive head trauma: neuroimaging mimics and diagnostic complexities.

Area of Science:

• Pediatric neurosurgery
• Child abuse diagnostics
• Forensic neuropathology

Background:

• Abusive head trauma (AHT) is a leading cause of death in children under puberty.
• Neuroimaging is crucial for diagnosing AHT due to varied presentations and unclear injury mechanisms.
• Numerous conditions can mimic AHT's clinical and imaging findings, complicating diagnosis.

Purpose of the Study:

• To provide a framework for diagnosing abusive head trauma (AHT) using neuroimaging.
• To review the literature and present illustrative cases of AHT.

Main Methods:

• Exhaustive literature review on AHT diagnosis and neuroimaging.
• Analysis of illustrative clinical cases from institutional experience.

Main Results:

• AHT diagnosis is challenging due to non-specific presentations and lack of pathognomonic imaging patterns.
• Misdiagnosis of AHT has severe repercussions for affected children.
• A structured approach is needed to differentiate AHT from other conditions.

Conclusions:

• A comprehensive framework is essential for accurate neuroimaging interpretation in suspected abusive head trauma (AHT).
• Distinguishing AHT from mimics requires careful consideration of clinical and imaging data.
• Improved diagnostic criteria and frameworks can mitigate misdiagnosis and its consequences.