Abelian Khoren,  Kaleem Musa,  Mclennan Kerrie,  Edwards Harriet

Final Pr. ID: Poster #: EDU-100

Abusive head trauma (AHT) is the leading cause of death in cases of physical child abuse. It primarily affects infants under two years of age, with the highest incidence in those younger than six months. Mortality may reach 30%, and approximately half of survivors suffer long-term neurological disability. Early and accurate differentiation of AHT from other causes of brain injury is therefore essential for safeguarding and appropriate management.
We present six cases of bilateral and three cases of unilateral intracranial haemorrhage in infants and children under the age of two years with confirmed child abuse. Of these, five had associated spinal injuries, two had associated retinal haemorrhages and features of hypoxic–ischaemic injury, and one had a skull fracture.
Using illustrations and findings from each case, we aim to (1) revisit abusive head trauma guidelines and imaging recommendations in both America and Europe, (2) the varied patterns of clinical presentation, and (3) outline the associated neuroimaging features which, either in isolation or in combination, can favour a shaking mechanism of injury rather than an isolated impact injury, as is more commonly seen in accidental head trauma. (4) We shall highlight how clinical outcomes can vary between cases due to factors such as cerebral ischaemia and raised intracranial pressure, (5) consider the importance of additional findings on spinal imaging and skeletal surveys, and (6) discuss the medicolegal implications of abusive head trauma.
After review, both the paediatric and general radiologist will have increased knowledge and confidence to raise suspicion to the paediatrician of potential abusive head trauma and suggest the correct next imaging steps to protect our vulnerable patients when presented with these neuroimaging findings. Read More

Authors:  Abelian Khoren , Kaleem Musa , Mclennan Kerrie , Edwards Harriet

Keywords:  Abusive Head Trauma, Intracranial Hemorrhage, Child Abuse

Bhatia Aashim,  Henry M.,  Feygin Tamara,  Christian Cindy

Final Pr. ID: Poster #: EDU-065

Abusive head trauma is associated with high morbidity and mortality. The evidence-based identification, care, and protection of infants and young children who are victims of AHT is critical. A diagnosis of AHT is made after careful consideration of the history provided, constellation of injuries identified, in conjunction with any additional diagnostic evaluation, as appropriate. This multidisciplinary educational module will focus on the evidence-based evaluation of intracranial findings when abusive head trauma (AHT) is a consideration, highlighting the importance of collaboration between child abuse pediatricians (CAPs) and pediatric neuroradiologists.

Framing the discussion with multiple cases, we will (1) describe the varied clinical presentations of abusive head trauma, (2) describe a general approach to the medical evaluation of abnormal intracranial findings when abuse is a concern; (3) present the differential diagnosis including traumatic and medical causes; (4) discuss appropriate imaging evaluation including neuroimaging (brain, spine) and skeletal imaging approaches; (5) report imaging findings found more commonly in AHT; (6) underscore the importance of collaboration between child abuse pediatricians and neuroradiologists; (7) highlight key literature, including the 2018 SPR-supported AHT consensus statement, to reference in practice, and, finally; (8) discuss consideration of language to include in imaging reports when abuse is a concern.

Following completion of the educational module, the learner will be familiar with the medical and imaging evaluations when AHT is considered, be able to describe imaging findings that are more commonly associated with AHT, and be familiar with references from the literature for self-study. Read More

Authors:  Bhatia Aashim , Henry M. , Feygin Tamara , Christian Cindy

Keywords:  Child Maltreatment, Abusive Head Trauma, Neuroradiology

Abelian Khoren,  Kaleem Musa,  Mclennan Kerrie,  Edwards Harriet

Final Pr. ID: Poster #: SCI-063

Abusive head trauma (AHT) is the leading cause of death in physical child abuse, predominantly affecting infants under two years. Early recognition of injury patterns inconsistent with reported mechanisms is critical for safeguarding and clinical management. This study reviewed neuroimaging findings in children under two presenting with head injury or altered neurological behaviour, focusing on the distribution and laterality of intracranial haemorrhage. Read More

Authors:  Abelian Khoren , Kaleem Musa , Mclennan Kerrie , Edwards Harriet

Keywords:  Abusive Head Trauma, Intracranial Hemorrhage, Child Abuse

Tutman Jeffrey,  Hedlund Gary

Final Pr. ID: Poster #: SCI-047

Accurate imaging characterization of chronic subdural hemorrhage (cSDH) has clinical and forensic implications, and continues to challenge the radiologist. The MRI characteristics of surgically proven cSDH were retrospectively reviewed in the context of known pathomorphology of the aging SDH. Read More

Authors:  Tutman Jeffrey , Hedlund Gary

Keywords:  Non-accidental trauma, Abusive Head Trauma