Spinal canal subdural hemorrhage was present in more than 60% of children with abusive head trauma who underwent thoracolumbar imaging in this series but was rare in those with accidental trauma.
Evidence of displacement or compression of cortical veins and sinuses from subdural hemorrhage or edema on MR venography was present in the majority of children with abusive head trauma. Evidence of direct trauma to the veins (lollipop sign) was identified in nearly half of cases. It is important to understand the superimposed effects of subdural hematoma and brain swelling on the veins and sinuses to differentiate it from cortical sinus and venous thrombosis.
Juvenile xanthogranuloma (JXG) is a rare benign self-limiting lesion presenting in early childhood. It is the commonest variant of non-Langerhans cell histiocytosis and usually presents as a cutaneous mass. It might have a systemic component and also might be associated with other conditions, notably neurofibromatosis and juvenile chronic myelogenous leukemia. Penile masses are unusual in childhood and we describe a case of JXG involving the penis. Although four cases of JXG of the penis have been reported in the literature, this is the first with imaging of the penile lesion. We discuss the clinical and radiological findings, differential diagnosis and management of these cases. High awareness of these lesions in the differential diagnosis of penile masses presenting in early childhood is important to avoid potentially unnecessary ablative genital surgery. Careful assessment should also be made for any systemic involvement and for associated pathologies.
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