Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

McKinney, Alexander M.; Thompson, Linda R.; Truwit, Charles L.; Velders, Scott; Karagülle, A. Tuba; Kiragu, Andrew

doi:10.1007/s00247-007-0673-0

Cited by 39 publications

(27 citation statements)

References 39 publications

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“…[14][15][16] However, this topic remains controversial. 17 In the present study, dotted calcification was seen in part of the laminar hemorrhage in a patient with shaken baby syndrome, and the remaining laminar signal-intensity loss in the area of laminar necrosis should be considered hemorrhage. Complicated mechanisms in shaken baby syndrome may contribute to laminar hemorrhage in the laminar necrosis detected in the present study.…”

Section: Discussionsupporting

confidence: 46%

Susceptibility-Weighted Imaging Findings of Cortical Laminar Necrosis in Pediatric Patients

Niwa¹,

Aida²,

Shishikura³

et al. 2008

AJNR Am J Neuroradiol

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Section: Discussionsupporting

confidence: 46%

Susceptibility-Weighted Imaging Findings of Cortical Laminar Necrosis in Pediatric Patients

Niwa¹,

Aida²,

Shishikura³

et al. 2008

AJNR Am J Neuroradiol

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“…Other case reports or series have also demonstrated DWI changes in white matter after NAT, suggesting that DWI is more sensitive than conventional MRI and more likely to detect lesions earlier in the evolution of an injury [Chan et al, 2003;Parizel et al, 2003;Ajilogba and Rao, 2006;Dan et al, 2008;McKinney et al, 2008]. These reports also noted large areas of dramatic diffusion restriction, which supports the belief that ischemia is a major component of brain injury in NAT, probably more so than DAI.…”

Section: Dwi In the Evaluation Of Natmentioning

confidence: 77%

“…These reports also noted large areas of dramatic diffusion restriction, which supports the belief that ischemia is a major component of brain injury in NAT, probably more so than DAI. In one report, 2 of the infants had unilateral deep white matter restricted diffusion with subdural hematomas that were small compared to the extent of HII, and no skull fracture [McKinney et al, 2008]. Craniocervical MR angiography and axial thin-section, fat-saturation images were negative for dissection, brainstem or cord injury.…”

Section: Dwi In the Evaluation Of Natmentioning

confidence: 99%

Advanced Neuroimaging in Children with Nonaccidental Trauma

2010

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Physical abuse associated with nonaccidental trauma (NAT) affects approximately 144,000 children per year in the USA and, frequently, these injuries affect the developing brain. Most infants with suspected NAT are initially evaluated by skull X-rays and computed tomography to determine whether fractures are present, the severity of the acute injury and the need for urgent neurosurgical intervention. Increasingly, magnetic resonance imaging (MRI) is conducted as it provides additional diagnostic and prognostic information about the extent and nature of the injury. In this review, we examine 4 MRI techniques as they apply to children who present acutely after NAT. Susceptibility-weighted imaging is a 3-D high-resolution MRI technique that is more sensitive than conventional imaging in detecting hemorrhagic lesions that are often associated with diffuse axonal injury (DAI). Magnetic resonance spectroscopy acquires metabolite information reflecting neuronal integrity and function from multiple brain regions and provides a sensitive, noninvasive assessment of neurochemical alterations that offers early prognostic information regarding outcome. Diffusion-weighted imaging (DWI) is based on differences in the diffusion of water molecules within the brain and has been shown to be very sensitive in the early detection of ischemic injury. It is now being used to study the direct effects of traumatic injury as well as those due to secondary ischemia. Diffusion tensor imaging is a form of DWI and allows better evaluation of white matter fiber tracts by taking advantage of the intrinsic directionality (anisotropy) of water diffusion in the human brain. It has been shown to be useful in identifying white matter abnormalities after DAI when conventional imaging appears normal. Although these imaging methods have been studied primarily in adults and children with accidental traumatic brain injury, it is clear that they have the potential to provide additional value in the imaging and clinical evaluation of children with NAT.

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“…Sometimes, the deep venous thrombi can disintegrate, leaving only the parenchymal venous infarcts visible on imaging [25][26][27]. Radiological mimics of neonatal ischemic brain injury Table 2 gives a brief overview of important radiological differential diagnoses of neonatal ischemic brain injury [28][29][30][31][32] (Figs. 17, 18 and 19).…”

Section: Perinatal Sinovenous Thrombosismentioning

confidence: 99%

Neonatal ischemic brain injury: what every radiologist needs to know

2012

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We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested.

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Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

Cited by 39 publications

References 39 publications

Susceptibility-Weighted Imaging Findings of Cortical Laminar Necrosis in Pediatric Patients

Susceptibility-Weighted Imaging Findings of Cortical Laminar Necrosis in Pediatric Patients

Advanced Neuroimaging in Children with Nonaccidental Trauma

Neonatal ischemic brain injury: what every radiologist needs to know

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