Navigation Links
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 computed tomography (CT) and MRI of the brain, spine, chest, abdomen and pelvis. They compared the imaging results to those from a group of 70 similarly aged children who were treated for accidental trauma.

Spinal canal subdural hemorrhage was evident in more than 60 percent of the children with abusive head trauma who underwent thoracolumbar imaging, or imaging of the thorax and the lumbar regions of the spine. In contrast, spinal canal subdural hemorrhage was rare in accidental trauma. Only one of the 70 children in the accidental trauma group had spinal subdural hemorrhage.

Dr. Choudhary indicated that more research is needed to improve understanding of the relationship between abusive trauma and spinal bleeding and provide another tool for criminal investigators.

"The diagnosis of abusive head trauma is complex," Dr. Choudhary said. "In most of these cases, the history does not fit with the clinical findings. The pathophysiology and diagnosis of abusive head trauma are still being hotly debated, particularly in the courts."

Dr. Choudhary added that it is crucial for radiologists to have all the facts at their disposal to be able to come to a confident diagnosis in possible cases of abusive head trauma. "The more we understand the diagnosis and the more research we have in this area, the better we will be at serving our most vulnerable patients," he said.


'/>"/>
Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

Related medicine news :

1. BMC selected spinal cord injury model system site by NIDRR
2. Spinal cord injuries associated with increased risk of heart disease
3. Frazier Rehab, UofL earn $2.2 million grant for Spinal Cord Injury Model System
4. Timing for clinical trials for stem cell therapy in spinal cord injuries is right
5. Commonly used supplement may improve recovery from spinal cord injuries
6. Spinal Surgery Riskier for Certain Patients, Study Finds
7. Wayne State University researcher to study spinal muscular atrophy
8. Bio-Engineered Spinal Discs Appear Successful in Rats
9. Severity of spinal cord injury has no impact on how adults rate their health, WSU research finds
10. Mainz University Medical Center deploys new system for therapy of metastatic spinal tumors
11. Spinal Stimulation Helps Paralyzed Man Regain Movement
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... ... Those who have experienced traumatic events may suffer from a complex set of ... or alcohol abuse, as a coping mechanism. To avoid this pain and suffering, Serenity ... event. , Trauma sufferers tend to feel a range of emotions, from depression, guilt, ...
(Date:6/24/2016)... ... 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced that 20 ... by their peers for this recognition are considered among the top 2 percent of ... honors as members of this year’s Legal Elite Hall of Fame: Miami Shareholders ...
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are sharpening ... Talker Award, an essay contest in which patients and their families pay tribute to ... at the 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this ...
(Date:6/24/2016)... ... 2016 , ... Strategic Capital Partners, LLC (SCP) in concert ... capital for emerging technology companies. SCP has delivered investment events and professional ... than a million dollars of capital investment for five companies. The ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... supporting the upcoming 2016 Miss Arizona pageant as its official Medspa Sponsor. Dr. ... Tempe, Mesa, and Chandler, Arizona. , Dr. Olson says the decision to ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 2016 Research and Markets has announced ... Analysis 2016 - Forecast to 2022" report to their ... contains up to date financial data derived from varied research ... trends with potential impact on the market during the next ... which comprises of sub markets, regional and country level analysis. ...
(Date:6/23/2016)... , June 23, 2016 Bracket , ... launch its next generation clinical outcomes platform, Bracket eCOA (SM) ... held on June 26 – 30, 2016 in ... first electronic Clinical Outcome Assessment product of its kind to ... #715. Bracket eCOA 6.0 is a flexible platform ...
(Date:6/23/2016)... NORTHBROOK, Ill. and BOGOTA, Colombia , June 23, 2016  Astellas today announced the ... joins Astellas Farma Brasil as the company,s second affiliate in Latin America . ... ... appointed General Manager of Astellas Farma Colombia ... ...
Breaking Medicine Technology: