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Spinal imaging of children presenting with abusive head trauma

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Three studies have addressed the value of spinal imaging amongst those with abusive head trauma (AHT) 1-3


Koumellis et al. conducted a case series 3:


  • 8/18 infants with AHT had spinal subdural collections
  • All had supratentorial and infra tentorial subdural haematoma
  • 6 / 8 were large and extended from the sacral region to cervical (2) thoracic (3) and lumbar (1) regions
  • Two were small in cervical or thoraco-lumbar respectively
  • 2 / 18 cases had fracture of thoracic spine seen on plain x ray, one of which had a small epidural haematoma

Choudhary and colleagues conducted a case-control study of 67 AHT cases versus 70 non-AHT cases 1:


  • 31 / 67 AHT had spinal subdural haemorrhage (SDH)
  • All had intracranial supratentorial and posterior fossa, subdural haematoma including 15 small intracranial SDH and 16 moderate SDH
  • The majority of the spinal SDH was along the posterior dura although some were circumferential and some exclusively anterior
  • Only 1 / 70 non-AHT had spinal subdural – this child had substantial posterior fossa injuries including displaced comminuted occipital bone fracture and cerebellar contusions

Kadom et al. conducted a case control study of 74 children less than three years of age; 38 with AHT 2


  • One child had a spinal subdural haemorrhage


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  1. Choudhary AK, Bradford RK, Dias MS, Moore GJ, Boal DK. Spinal subdural hemorrhage in abusive head trauma: a retrospective study. Radiology. 2012;262(1):216-223. [Pubmed]

  2. Kadom N, Khademian Z, Vezina G, Shalaby-Rana E, Rice A, Hinds T. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma. Pediatric Radiology. 2014;44(7):839-848 [Pubmed]

  3. Koumellis P, McConachie NS, Jaspan T. Spinal subdural haematomas in children with non-accidental head injury. Archives of Disease in Childhood. 2009;94(3):216-219.[Pubmed]






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