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Spinal bleeding with brain injury may suggest abuse in young children
Date:11/7/2011

OAK BROOK, Ill. -- A new study found that spinal bleeding is found often in young children who are victims of abusive trauma. The findings support performing complete spine imaging for children undergoing brain magnetic resonance imaging (MRI) for moderate or severe traumatic brain injury and suggest a pathway for distinguishing between abusive and accidental injury. The study is published online in the journal Radiology.

According to the researchers, abusive head trauma is the leading cause of significant traumatic brain injury in infants, with a 20 to 38 percent mortality rate and significant neurological and developmental impairment in 30 to 78 percent of survivors.

The radiologic features of abusive head trauma include bleeding within the skull and brain injury. Spinal injuries like spinal subdural hemorrhage -- bleeding in the space between the spinal cord and its tough outer membrane -- are another feature of trauma that may be overlooked clinically in non-fatal cases because of coexistent brain injury and traumatic coma.

"Imaging the whole spine is important in cases of abuse for two reasons," said study author Arabinda Kumar Choudhary, M.D., MRCP, FRCR, pediatric radiologist at Penn State Milton S. Hershey Medical Center and Penn State College of Medicine in Hershey, Pa. "Most of the spinal injuries in abusive head trauma are clinically silent because of extensive injuries elsewhere and lack of a clinical history suggestive of spinal injury. It is important to rule out any significant injury to the spine and spinal cord. Also, spine imaging allows complications of subdural hemorrhage collecting in the spinal canal to be diagnosed earlier."

To study the incidence of spinal subdural hemorrhage, Dr. Choudhary and colleagues looked at clinical data and imaging records for 252 children aged two years old or younger who underwent treatment for abusive head trauma at the medical center. Imaging results included compu
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Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

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