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Spinal subdural hemorrhage in abusive head trauma: a pictorial review
Flavio Garcia-Pires1, Sateesh Jayappa2, Shivang Desai3
1Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA. FLGarciapires@uams.edu.
Insights
Abusive head trauma (AHT) is linked to spinal injuries like spinal subdural hemorrhage (SDH). Spine imaging in AHT evaluations aids diagnosis and management for affected children and siblings.
Area of Science:
- Medical Imaging
- Pediatric Traumatology
- Neuropathology
Background:
- Abusive head trauma (AHT) is frequently associated with spinal injuries.
- Spinal subdural hemorrhage (SDH) is a recognized pattern of injury in AHT.
- Identifying spinal injuries is critical for managing the index child and siblings.
Purpose of the Study:
- To review the imaging appearance of spinal subdural hemorrhage (SDH) in abusive head trauma (AHT).
- To discuss the challenges in identifying spinal SDH.
- To explore the mechanisms of spinal SDH development in AHT.
Main Methods:
- Pictorial review of spinal imaging findings in AHT.
- Discussion of diagnostic challenges and injury mechanisms.
- Literature synthesis on spinal SDH in AHT.
Main Results:
- Spinal SDH is a key indicator of AHT.
- Accurate identification of spinal SDH requires careful review of imaging.
- Understanding injury mechanisms aids in diagnosis.
Conclusions:
- Spine imaging in the AHT workup adds significant value to patient management.
- Early identification of spinal SDH impacts clinical decisions for the child and family.
- Further research into AHT-related spinal injuries is warranted.
Abstract:
A growing body of evidence links abusive head trauma (AHT) to patterns of direct and indirect spinal injuries, such as spinal subdural hemorrhage (SDH). Identification of evidence of spinal injury such as spinal SDH plays a crucial role in the diagnosis and subsequent management of the index child with AHT and his or her siblings. In a value-based practice of medicine, it can be argued that adding spine imaging to identify spinal SDH in the workup of AHT adds value to both the short- and long-term management of the patient. This pictorial review describes the normal appearance of spinal SDH and challenges of identifying spinal SDH, and it explores the mechanism of spinal SDH development in AHT.
