BROOKLYN 3STUDENTS

Bridgette MAIR

Fri 30th Aug 2013Session 3 / Talk 4

13:45 – 13:55

ABSTRACTSubdural haematomas are the most common form of traumatic injury and make up 80% of head injury from non-accidental injuries. Diagnosis of subdural haematomas can be difficult as the child regularly has non-specific symptoms and lacks external cues. Neuroimaging is a fundamental investigation in obtaining diagnosis of subdural haematomas. It is therefore essential to understand the role of MRI in demonstrating subdural haematomas for diagnosis to be achieved, enabling correct management steps to be ascertained improving the prognosis of paediatrics subjected to non-accidental injury. The aim of this literature review is to explain the role MRU plays in diagnosing subdural haematomas in NAI paediatrics. This was completed by reviewing 15 literature articles from 1999 to understand the role it plays and why. It was concluded that while CT remains the most appropriate initial modality of choice for suspected NAI cases die to accessibility, speed and ease, MRI is the test of choice to demonstrate SDH due to its higher level specificity and aging of multiple haematomas if present.

The role of magnetic resonance imaging in diagnosing subdural

haematomas in non-

accidental injury

paediatrics

Nia Glassie Kahui Twins

Date of Injury Name Age Cause of death

May 2006 Kahui Twins 3 months Severe head injuries

August 2007 Nia Glassie 3 years Brain injuries and other abuse

January 2008 Tahani Mahomed 11 weeks Severe brain injuries

August 2009 Kash McKinnon 3 years Severe head injuries

September 2009 Hail-Sage McClutchie 22 months Serious head injuries

July 2010 Cezar Taylor 6 months Serious head injuries

April 2011 Serenity Scott 5 months Serious brain injury

Patient AgeClinical

PresentationCT Time MRI Time Diagnosis

A 2 monthsFever – 24 hours,

seizures, anemia

Day of

admission

15 days post

admission

MRI showed multiple

SDH’s of different ages.

NAI confirmed

B 3½ monthsAnorexia and

drowsiness

Day of

admission

5 days post

admission

CT showed chronic SDH.

MRI confirmed an acute

SDH also. NAI was

confirmed

C 5½ monthsH/O head trauma,

LOC, irritable

Day of

admission

20 days post

admission

CT showed SDH. MRI

showed multiple SDH of

different ages. NAI

confirmed

Patient AgeClinical

PresentationCT Time MRI Time Diagnosis

D 4½ monthsLeft sided

seizures

Day of

admission

20 days post

admission

CT and MRI both showed

abnormalities with

haemorrhage noted. MRI

was suggestive of NAI but

could not be confirmed

E 1½ monthsRespiratory

distress, apnoea

Day of

admission

2 days post

admission

CT showed malformation

due to injury. MRI showed

multiple SDH’s of different

ages in multiple brain

lobes. NAI confirmed

F 2 months ApnoeaDay of

admission

6 days post

admission

Skeletal survey was done

on admission showing

numerous fractures. CT

was normal. MRI showed

a chronic SDH. NAI

confirmed

Image shows subdural haematomas performed by CT-image set A, and by MRI-image set 2

AnyQuestions

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