Research Reports - Parenchymal brain laceration as a predictor of abusive head trauma

AJNR Am J Neuroradiol. 2015 Oct 15. [Epub ahead of print]

Palifka LA(1), Frasier LD(2), Metzger RR(2), Hedlund GL(2).

BACKGROUND AND PURPOSE: Accurate differentiation of abusive head trauma and
accidental head injury in infants and young children is critical and impacts
clinical care, patient prognosis, forensic investigations, and medicolegal
proceedings. No specific finding seen on cross-sectional brain imaging has been
reported to distinguish abusive head trauma from accidental injury. Our study
investigated whether a specific imaging finding, parenchymal brain laceration, is
unique to children diagnosed with abusive head trauma.
MATERIALS AND METHODS: We retrospectively identified 137 patients with abusive
head trauma and 28 patients who incurred moderate to severe accidental brain
injury. Brain MR imaging represented the imaging standard for characterizing
intracranial injuries.
RESULTS: Among the abusive head trauma cohort, parenchymal brain lacerations were
identified in 18 patients, while none were identified in any patients with
accidental injury.
CONCLUSIONS: Our findings are in concurrence with the existing forensic,
pathology, and imaging literature, which suggests that parenchymal brain
lacerations may be related to abusive injury mechanisms.

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