Pediatric Radiology

, Volume 48, Issue 8, pp 1048–1065 | Cite as

Consensus statement on abusive head trauma in infants and young children

  • Arabinda Kumar ChoudharyEmail author
  • Sabah Servaes
  • Thomas L. Slovis
  • Vincent J. Palusci
  • Gary L. Hedlund
  • Sandeep K. Narang
  • Joëlle Anne Moreno
  • Mark S. Dias
  • Cindy W. Christian
  • Marvin D. NelsonJr
  • V. Michelle Silvera
  • Susan Palasis
  • Maria Raissaki
  • Andrea Rossi
  • Amaka C. Offiah


Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic–ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.


Abusive head trauma Child abuse Children Computed tomography Consensus statement Infants Magnetic resonance imaging Mimics Unsubstantiated theories 



We are grateful to the fellows at Children’s Hospital of Philadelphia who reviewed the references for this manuscript (Andrew J. Degnan, Rachelle Durand, Edward Fenlon, Ami Gokli, Aditi Hendi, James Hogan, Fang Lu, Ian Mills, Christy Pomeranz, Jordan Rapp and Michele Retrouvey).

Compliance with ethical standards

Conflicts of interest

Dr. Narang has been paid as an expert consultant/witness in cases of abusive head trauma. Drs. Choudhary, Servaes, Christian, Hedlund, Dias, Nelson, Palasis, Rossi and Offiah provide medical–legal expert work in child abuse cases.


  1. 1.
    Narang S (2011) A Daubert analysis of abusive head trauma/shaken baby syndrome. Hous J Health L Pol'y 11:505–633Google Scholar
  2. 2.
    American Academy of Pediatrics (2015) Understanding abusive head trauma in infants and children: answers from America’s pediatricians. Accessed 17 April 2018
  3. 3.
    Narang SK, Estrada C, Greenberg S et al (2016) Acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. J Pediatr 177:273–278PubMedCrossRefGoogle Scholar
  4. 4.
    Meyer JS, Gunderman R, Coley BD et al (2011) ACR appropriateness criteria® on suspected physical abuse — child. J Am Coll Radiol 8:87–94PubMedCrossRefGoogle Scholar
  5. 5.
    Strouse PJ (2016) Child abuse: we have problems. Pediatr Radiol 46:587–590PubMedCrossRefGoogle Scholar
  6. 6.
    Tuerkheimer D (2009) The next innocence project: shaken baby syndrome and the criminal courts. Wash U L Rev 87:1–58Google Scholar
  7. 7.
    Bazelon E (2011) Shaken-baby syndrome faces new questions in court. New York Times Magazine. Accessed 17 Dec 2015
  8. 8.
    Keenan HT, Runyan DK, Marshall SW et al (2003) A population-based study of inflicted traumatic brain injury in young children. JAMA 290:621–626PubMedCrossRefGoogle Scholar
  9. 9.
    Parks SE, Kegler SR, Annest JL et al (2012) Characteristics of fatal abusive head trauma among children in the USA: 2003-2007: an application of the CDC operational case definition to national vital statistics data. Inj Prev 18:193–199PubMedCrossRefGoogle Scholar
  10. 10.
    Christian CW, Block R, Committee on Child Abuse and Neglect, American Academy of Pediatrics (2009) Abusive head trauma in infants and children. Pediatrics 123:1409–1411PubMedCrossRefGoogle Scholar
  11. 11.
    Caffey J (1946) Multiple fractures in the long bones of infants suffering from chronic subdural hematoma. Am J Roentgenol Radium Ther 56:163–173PubMedGoogle Scholar
  12. 12.
    Kempe CH, Silverman FN, Steele BF et al (1962) The battered-child syndrome. JAMA 181:17–24PubMedCrossRefGoogle Scholar
  13. 13.
    Caffey J (1972) The parent-infant traumatic stress syndrome; (Caffey-Kempe syndrome), (battered babe syndrome). Am J Roentgenol Radium Therapy Nucl Med 114:218–229CrossRefGoogle Scholar
  14. 14.
    Caffey J (1972) On the theory and practice of shaking infants. Its potential residual effects of permanent brain damage and mental retardation. Am J Dis Child 124:161–169PubMedCrossRefGoogle Scholar
  15. 15.
    Caffey J (1974) The whiplash shaken infant syndrome: manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain damage and mental retardation. Pediatrics 54:396–403PubMedGoogle Scholar
  16. 16.
    Duhaime AC, Gennarelli TA, Thibault LE et al (1987) The shaken baby syndrome. A clinical, pathological and biomechanical study. J Neurosurg 66:409–415PubMedCrossRefGoogle Scholar
  17. 17.
    Kemp AM (2011) Abusive head trauma: recognition and the essential investigation. Arch Dis Child Educ Pract Ed 96:202–208PubMedCrossRefGoogle Scholar
  18. 18.
    Smith MJ (1950) Subdural hematoma with multiple fractures. AJR Am J Roentgenol 63:342–344Google Scholar
  19. 19.
    Lis EF, Frauenberger GS (1950) Multiple fractures associated with subdural hematoma in infancy. Pediatrics 6:890–892PubMedGoogle Scholar
  20. 20.
    Silverman FN (1953) The roentgen manifestations of unrecognized skeletal trauma in infants. Am J Roentgenol Radium Therapy Nucl Med 69:413–427Google Scholar
  21. 21.
    Woolley PV Jr, Evans WA Jr (1955) Significance of skeletal lesions in infants resembling those of traumatic origin. J Am Med Assoc 158:539–543PubMedCrossRefGoogle Scholar
  22. 22.
    Ommaya AK, Yarnell P (1969) Subdural haematoma after whiplash injury. Lancet 2:237–239PubMedGoogle Scholar
  23. 23.
    Guthkelch AN (1971) Infantile subdural haematoma and its relationship to whiplash injuries. Br Med J 2:430–431PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Kiffney GT Jr (1964) The eye of the "battered child". Arch Ophthalmol 72:231–233PubMedCrossRefGoogle Scholar
  25. 25.
    Duhaime AC, Alario AJ, Lewander WJ et al (1992) Head injury in very young children: mechanisms, injury types and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age. Pediatrics 90:179–185PubMedGoogle Scholar
  26. 26.
    Levin AV, Christian CW, Committee on Child Abuse and Neglect, Section on Ophthalmology (2010) The eye examination in the evaluation of child abuse. Pediatrics 126:376–380PubMedCrossRefGoogle Scholar
  27. 27.
    Johnson DL, Boal D, Baule R (1995) Role of apnea in nonaccidental head injury. Pediatr Neurosurg 23:305–310PubMedCrossRefGoogle Scholar
  28. 28.
    Ichord RN, Naim M, Pollock AN et al (2007) Hypoxic-ischemic injury complicates inflicted and accidental traumatic brain injury in young children: the role of diffusion-weighted imaging. J Neurotrauma 24:106–118PubMedCrossRefGoogle Scholar
  29. 29.
    Bayir H, Kochanek PM, Kagan VE (2006) Oxidative stress in immature brain after traumatic brain injury. Dev Neurosci 28:420–431PubMedCrossRefGoogle Scholar
  30. 30.
    Starling SP, Patel S, Burke BL et al (2004) Analysis of perpetrator admissions to inflicted traumatic brain injury in children. Arch Pediatr Adolesc Med 158:454–458PubMedCrossRefGoogle Scholar
  31. 31.
    Adamsbaum C, Grabar S, Mejean N et al (2010) Abusive head trauma: judicial admissions highlight violent and repetitive shaking. Pediatrics 126:546–555PubMedCrossRefGoogle Scholar
  32. 32.
    Vinchon M, de Foort-Dhellemmes S, Desurmont M et al (2010) Confessed abuse versus witnessed accidents in infants: comparison of clinical, radiological and ophthalmological data in corroborated cases. Childs Nerv Syst 26:637–645PubMedCrossRefGoogle Scholar
  33. 33.
    Dias MS (2011) The case for shaking. In: Jenny C (ed) Child abuse and neglect: diagnosis, treatment and evidence. Saunders/Elsevier, St. Louis, pp 364–372CrossRefGoogle Scholar
  34. 34.
    Silverman FN (1972) Unrecognized trauma in infants, the battered child syndrome and the syndrome of Ambroise Tardieu. Rigler Lecture Radiology 104:337–353PubMedGoogle Scholar
  35. 35.
    Jenny C (2003) Modes of presentation of inflicted childhood trauma. In: Reece RM, Nicholson CE (eds) Inflicted childhood neurotrauma: proceedings of a conference sponsored by Department of Health and Human Services, Oct. 10–11, 2002, Bethesda, Maryland American Academy of Pediatrics, S.l., pp 48–63Google Scholar
  36. 36.
    Arbogast KB, Margulies SS, Christian CW (2005) Initial neurologic presentation in young children sustaining inflicted and unintentional fatal head injuries. Pediatrics 116:180–184PubMedCrossRefGoogle Scholar
  37. 37.
    Borgialli DA, Mahajan P, Hoyle JD et al (2016) Performance of the pediatric Glasgow coma scale score in the evaluation of children with blunt head trauma. Acad Emerg Med 23:878–884PubMedCrossRefGoogle Scholar
  38. 38.
    Hettler J, Greenes DS (2003) Can the initial history predict whether a child with a head injury has been abused? Pediatrics 111:602–607PubMedCrossRefGoogle Scholar
  39. 39.
    Jenny C, Hymel KP, Ritzen A et al (1999) Analysis of missed cases of abusive head trauma. JAMA 281:621–626PubMedCrossRefGoogle Scholar
  40. 40.
    Kemp AM, Jaspan T, Griffiths J et al (2011) Neuroimaging: what neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review. Arch Dis Child 96:1103–1112PubMedCrossRefGoogle Scholar
  41. 41.
    Maguire SA, Kemp AM, Lumb RC et al (2011) Estimating the probability of abusive head trauma: a pooled analysis. Pediatrics 128:e550–e564PubMedGoogle Scholar
  42. 42.
    Palifka LA, Frasier LD, Metzger RR, Hedlund GL (2016) Parenchymal brain laceration as a predictor of abusive head trauma. AJNR Am J Neuroradiol 37:163–168Google Scholar
  43. 43.
    Kelly P, John S, Vincent AL et al (2015) Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team. Arch Dis Child 100:1123–1130PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Hennes H, Kini N, Palusci VJ (2001) The epidemiology, clinical characteristics and public health implications of shaken baby syndrome. J Aggress Maltreat Trauma 5:19–40CrossRefGoogle Scholar
  45. 45.
    Palusci VJ (2011) Risk factors and services for child maltreatment among infants and young children. Child Youth Serv Rev 33:1374–1382CrossRefGoogle Scholar
  46. 46.
    Feldman KW, Bethel R, Shugerman RP et al (2001) The cause of infant and toddler subdural hemorrhage: a prospective study. Pediatrics 108:636–646PubMedCrossRefGoogle Scholar
  47. 47.
    Dias MS (2002) Inflicted head injury: future directions and prevention. Neurosurg Clin 13:247–257CrossRefGoogle Scholar
  48. 48.
    Abel JM, Gennarelli TA, Segawa H (1978) Incidence and severity of cerebral concussion in the rhesus monkey following sagittal plane angular acceleration. In Proceeding of 22nd Stapp Car Crash Conference, Society for Automotive Engineers, pp 35–53Google Scholar
  49. 49.
    Margulies SS, Thibault LE, Gennarelli TA (1990) Physical model simulations of brain injury in the primate. J Biomech 23:823–836PubMedCrossRefGoogle Scholar
  50. 50.
    Nahum AM, Smith RW (1976) An experimental model for closed head impact injury. In: Proceedings of 20th Stapp Car Crash Conference. Society of Automotive Engineers, pp 783–814Google Scholar
  51. 51.
    Prange MT, Coats B, Duhaime AC et al (2003) Anthropomorphic simulations of falls, shakes and inflicted impacts in infants. J Neurosurg 99:143–150PubMedCrossRefGoogle Scholar
  52. 52.
    Chadwick DL, Bertocci G, Castillo E et al (2008) Annual risk of death resulting from short falls among young children: less than 1 in 1 million. Pediatrics 121:1213–1224PubMedCrossRefGoogle Scholar
  53. 53.
    Aoki N, Masuzawa H (1984) Infantile acute subdural hematoma. J Neurosurg 61:273–280PubMedCrossRefGoogle Scholar
  54. 54.
    Benoit R, Watts DD, Dwyer K et al (2000) Windows 99: a source of suburban pediatric trauma. J Trauma 49:477–481PubMedCrossRefGoogle Scholar
  55. 55.
    Claydon SM (1996) Fatal extradural hemorrhage following a fall from a baby bouncer. Pediatr Emerg Care 12:432–434PubMedCrossRefGoogle Scholar
  56. 56.
    Denton S, Mileusnic D (2003) Delayed sudden death in an infant following an accidental fall: a case report with review of the literature. Am J Forensic Med Pathol 24:371–376PubMedCrossRefGoogle Scholar
  57. 57.
    Docherty E, Hassan A, Burke D (2010) Things that go bump ... bump ... bump: an analysis of injuries from falling down stairs in children based at Sheffield Children’s Hospital. Emerg Med J 27:207–208PubMedCrossRefGoogle Scholar
  58. 58.
    Gruskin KD, Schutzman SA (1999) Head trauma in children younger than 2 years: are there predictors for complications? Arch Pediatr Adolesc Med 153:15–20PubMedCrossRefGoogle Scholar
  59. 59.
    Hall JR, Reyes HM, Horvat M et al (1989) The mortality of childhood falls. J Trauma 29:1273–1275PubMedCrossRefGoogle Scholar
  60. 60.
    Kim KA, Wang MY, Griffith PM et al (2000) Analysis of pediatric head injury from falls. Neurosurg Focus 8:1–5CrossRefGoogle Scholar
  61. 61.
    Levene S, Bonfield G (1991) Accidents on hospital wards. Arch Dis Child 66:1047–1049PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Joffe M, Ludwig S (1988) Stairway injuries in children. Pediatrics 82:457–461PubMedGoogle Scholar
  63. 63.
    Murray JA, Chen D, Velmahos GC et al (2000) Pediatric falls: is height a predictor of injury and outcome? Am Surg 66:863–865PubMedGoogle Scholar
  64. 64.
    Park SH, Cho BM, Oh SM (2004) Head injuries from falls in preschool children. Yonsei Med J 45:229PubMedCrossRefGoogle Scholar
  65. 65.
    Partington MD, Swanson JA, Meyer FB (1991) Head injury and the use of baby walkers: a continuing problem. Ann Emerg Med 20:652–654PubMedCrossRefGoogle Scholar
  66. 66.
    Reiber GD (1993) Fatal falls in childhood. How far must children fall to sustain fatal head injury? Report of cases and review of the literature. Am J Forensic Med Pathol 14:201–207PubMedCrossRefGoogle Scholar
  67. 67.
    Ruddick C, Platt MW, Lazaro C (2010) Head trauma outcomes of verifiable falls in newborn babies. Arch Dis Child Fetal Neonatal Ed 95:F144–F145PubMedGoogle Scholar
  68. 68.
    Sturm V, Knecht PB, Landau K, Menke MN (2009) Rare retinal haemorrhages in translational accidental head trauma in children. Eye 23:1535–1541Google Scholar
  69. 69.
    Trenchs V, Curcoy AI, Morales M et al (2008) Retinal haemorrhages in head trauma resulting from falls: differential diagnosis with non-accidental trauma in patients younger than 2 years of age. Childs Nerv Syst 24:815–820PubMedCrossRefGoogle Scholar
  70. 70.
    Williams RA (1991) Injuries in infants and small children resulting from witnessed and corroborated free falls. J Trauma 31:1350–1352PubMedCrossRefGoogle Scholar
  71. 71.
    Zielinski AE, Rochette LM, Smith GA (2012) Stair-related injuries to young children treated in US emergency departments, 1999-2008. Pediatrics 129:721–727PubMedCrossRefGoogle Scholar
  72. 72.
    Billmire ME, Myers PA (1985) Serious head injury in infants: accident or abuse? Pediatrics 75:340–342PubMedGoogle Scholar
  73. 73.
    Chadwick DL, Chin S, Salerno C et al (1991) Deaths from falls in children: how far is fatal? J Trauma 31:1353–1355PubMedCrossRefGoogle Scholar
  74. 74.
    Chiaviello CT, Christoph RA, Bond GR (1994) Stairway-related injuries in children. Pediatrics 94:679–681PubMedGoogle Scholar
  75. 75.
    Chiaviello CT, Christoph RA, Bond GR (1994) Infant walker-related injuries: a prospective study of severity and incidence. Pediatrics 93:974–976PubMedGoogle Scholar
  76. 76.
    Ewing-Cobbs L, Kramer L, Prasad M et al (1998) Neuroimaging, physical and developmental findings after inflicted and noninflicted traumatic brain injury in young children. Pediatrics 102:300–307PubMedCrossRefGoogle Scholar
  77. 77.
    Goldstein B, Kelly MM, Bruton D et al (1993) Inflicted versus accidental head injury in critically injured children. Crit Care Med 21:1328–1332PubMedCrossRefGoogle Scholar
  78. 78.
    Helfer RE, Slovis TL, Black M (1977) Injuries resulting when small children fall out of bed. Pediatrics 60:533–535PubMedGoogle Scholar
  79. 79.
    Kelly P, Hayes I (2004) Infantile subdural haematoma in Auckland, New Zealand: 1988-1998. N Z Med J 117:U1047PubMedGoogle Scholar
  80. 80.
    Kravitz H, Driessen G, Gomberg R et al (1969) Accidental falls from elevated surfaces in infants from birth to one year of age. Pediatrics 44:869–876Google Scholar
  81. 81.
    Lyons TJ, Oates RK (1993) Falling out of bed: a relatively benign occurrence. Pediatrics 92:125–127PubMedGoogle Scholar
  82. 82.
    Nimityongskul P, Anderson LD (1987) The likelihood of injuries when children fall out of bed. J Pediatr Orthop 7:184–186PubMedCrossRefGoogle Scholar
  83. 83.
    Reece RM, Sege R (2000) Childhood head injuries: accidental or inflicted? Arch Pediatr Adolesc Med 154:11–15PubMedGoogle Scholar
  84. 84.
    Selbst SM, Baker MD, Shames M (1990) Bunk bed injuries. Am J Dis Child 144:721–723PubMedGoogle Scholar
  85. 85.
    Smith MD, Burrington JD, Woolf AD (1975) Injuries in children sustained in free falls: an analysis of 66 cases. J Trauma 15:987–991PubMedCrossRefGoogle Scholar
  86. 86.
    Kahn DJ, Fisher PD, Hertzler DA (2017) Variation in management of in-hospital newborn falls: a single-center experience. J Neurosurg Pediatr 20:176–182PubMedCrossRefGoogle Scholar
  87. 87.
    Levin AV, Luyet FM, Knox BL (2016) Ophthalmologic concerns in abusive head trauma. J Fam Violence 31:797–804CrossRefGoogle Scholar
  88. 88.
    Gill JR, Goldfeder LB, Armbrustmacher V et al (2009) Fatal head injury in children younger than 2 years in New York City and an overview of the shaken baby syndrome. Arch Pathol Lab Med 133:619–627PubMedGoogle Scholar
  89. 89.
    Kivlin JD, Simons KB, Lazoritz S, Ruttum MS (2000) Shaken baby syndrome. Ophthalmology 107:1246–1254Google Scholar
  90. 90.
    Morad Y, Kim YM, Armstrong DC et al (2002) Correlation between retinal abnormalities and intracranial abnormalities in the shaken baby syndrome. Am J Ophthalmol 134:354–359PubMedCrossRefGoogle Scholar
  91. 91.
    Morad Y, Wygnansky-Jaffe T, Levin AV (2010) Retinal haemorrhage in abusive head trauma. Clin Exp Ophthalmol 38:514–520PubMedCrossRefGoogle Scholar
  92. 92.
    Agrawal S, Peters MJ, Adams GGW et al (2012) Prevalence of retinal hemorrhages in critically ill children. Pediatrics 129:e1388–e1396PubMedCrossRefGoogle Scholar
  93. 93.
    Levin AV (2010) Retinal hemorrhage in abusive head trauma. Pediatrics 126:961–970PubMedCrossRefGoogle Scholar
  94. 94.
    Binenbaum G, Chen W, Huang J et al (2016) The natural history of retinal hemorrhage in pediatric head trauma. J AAPOS 20:131–135PubMedPubMedCentralCrossRefGoogle Scholar
  95. 95.
    Servaes S, Brown SD, Choudhary AK et al (2016) The etiology and significance of fractures in infants and young children: a critical multidisciplinary review. Pediatr Radiol 46:591–600PubMedCrossRefGoogle Scholar
  96. 96.
    Anderst JD, Carpenter SL, Abshire TC et al (2013) Evaluation for bleeding disorders in suspected child abuse. Pediatrics 131:e1314–e1322PubMedCrossRefGoogle Scholar
  97. 97.
    Choudhary AK, Jha B, Boal DK, Dias M (2010) Occipital sutures and its variations: the value of 3D-CT and how to differentiate it from fractures using 3D-CT? Surg Radiol Anat 32:807–816PubMedCrossRefGoogle Scholar
  98. 98.
    Kemp AM, Rajaram S, Mann M et al (2009) What neuroimaging should be performed in children in whom inflicted brain injury (iBI) is suspected? A systematic review. Clin Radiol 64:473–483PubMedCrossRefGoogle Scholar
  99. 99.
    Barber I, Kleinman PK (2014) Imaging of skeletal injuries associated with abusive head trauma. Pediatr Radiol 44:S613–S620PubMedCrossRefGoogle Scholar
  100. 100.
    Girard N, Brunel H, Dory-Lautrec P et al (2016) Neuroimaging differential diagnoses to abusive head trauma. Pediatr Radiol 46:603–614PubMedCrossRefGoogle Scholar
  101. 101.
    Slovis TL, Strouse PJ, Strauss KJ (2015) Radiation exposure in imaging of suspected child abuse: benefits versus risks. J Pediatr 167:963–968PubMedCrossRefGoogle Scholar
  102. 102.
    Kuppermann N, Holmes JF, Dayan PS et al (2009) Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374:1160–1170PubMedCrossRefGoogle Scholar
  103. 103.
    Magana JN, Kuppermann N (2017) The PECARN TBI rules do not apply to abusive head trauma. Acad Emerg Med 24:382–384PubMedCrossRefGoogle Scholar
  104. 104.
    National Association of Children’s Hospitals and Related Institutions (2011) Defining the children’s hospital role in child maltreatment, 2nd edn. Accessed 05 June 2017
  105. 105.
    Bechtel K, Stoessel K, Leventhal JM et al (2004) Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics 114:165–168PubMedCrossRefGoogle Scholar
  106. 106.
    Ewing-Cobbs L, Prasad M, Kramer L et al (2000) Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury. Childs Nerv Syst 16:25–33PubMedCrossRefGoogle Scholar
  107. 107.
    Myhre MC, Grogaard JB, Dyb GA et al (2007) Traumatic head injury in infants and toddlers. Acta Paediatr 96:1159–1163PubMedCrossRefGoogle Scholar
  108. 108.
    Tung GA, Kumar M, Richardson RC et al (2006) Comparison of accidental and nonaccidental traumatic head injury in children on noncontrast computed tomography. Pediatrics 118:626–633PubMedCrossRefGoogle Scholar
  109. 109.
    Hedlund G (2015) Abusive head trauma: extraaxial hemorrhage and nonhemic collections. In: Kleinman PK (ed) Diagnostic imaging of child abuse. Cambridge University Press, Cambridge, pp 394–452CrossRefGoogle Scholar
  110. 110.
    Bradford R, Choudhary AK, Dias MS (2013) Serial neuroimaging in infants with abusive head trauma: timing abusive injuries. J Neurosurg Pediatr 12:110–119PubMedCrossRefGoogle Scholar
  111. 111.
    Zouros A, Bhargava R, Hoskinson M et al (2004) Further characterization of traumatic subdural collections of infancy. J Neurosurg Pediatr 100:512–518CrossRefGoogle Scholar
  112. 112.
    Vezina G (2009) Assessment of the nature and age of subdural collections in nonaccidental head injury with CT and MRI. Pediatr Radiol 39:586–590PubMedCrossRefGoogle Scholar
  113. 113.
    Grant P (2015) Abusive head trauma: parenchymal injury. In: Kleinman PK (ed) Diagnostic imaging of child abuse. Cambridge University Press, Cambridge, pp 453–486CrossRefGoogle Scholar
  114. 114.
    Choudhary AK, Bradford R, Dias MS et al (2015) Venous injury in abusive head trauma. Pediatr Radiol 45:1803–1813PubMedCrossRefGoogle Scholar
  115. 115.
    Nelson MD Jr (2009) Unraveling the puzzle. Pediatr Radiol 39:199PubMedCrossRefGoogle Scholar
  116. 116.
    Mack J, Squier W, Eastman J (2009) Anatomy and development of the meninges: implications for subdural collections and CSF circulation. Pediatr Radiol 39:200–210PubMedCrossRefGoogle Scholar
  117. 117.
    Choudhary AK, Ishak R, Zacharia TT et al (2014) Imaging of spinal injury in abusive head trauma: a retrospective study. Pediatr Radiol 44:1130–1140PubMedCrossRefGoogle Scholar
  118. 118.
    Kemp A, Cowley L, Maguire S (2014) Spinal injuries in abusive head trauma: patterns and recommendations. Pediatr Radiol 44:S604–S612PubMedCrossRefGoogle Scholar
  119. 119.
    Choudhary AK, Bradford RK, Dias MS et al (2012) Spinal subdural hemorrhage in abusive head trauma: a retrospective study. Radiology 262:216–223PubMedCrossRefGoogle Scholar
  120. 120.
    Brennan LK, Rubin D, Christian CW et al (2009) Neck injuries in young pediatric homicide victims. J Neurosurg Pediatr 3:232–239PubMedCrossRefGoogle Scholar
  121. 121.
    Koumellis P, McConachie NS, Jaspan T (2009) Spinal subdural haematomas in children with non-accidental head injury. Arch Dis Child 94:216–219PubMedCrossRefGoogle Scholar
  122. 122.
    Bandak FA (2005) Shaken baby syndrome: biomechanics analysis of injury mechanisms. Forensic Sci Int 151:71–79PubMedCrossRefGoogle Scholar
  123. 123.
    Woodall TT (2009) In the court of criminal appeals of Tennessee at Nashville. Accessed on 30 July 2017
  124. 124.
    Gabaeff SC (2011) Challenging the pathophysiologic connection between subdural hematoma, retinal hemorrhage and shaken baby syndrome. West J Emerg Med 12:144–158PubMedPubMedCentralGoogle Scholar
  125. 125.
    Leventhal JM, Edwards GA (2017) Flawed theories to explain child physical abuse: what are the medical-legal consequences? JAMA 318:1317–1318PubMedCrossRefGoogle Scholar
  126. 126.
    Martin-Millan M, Hernandez JL, Matorras P et al (2005) Multiple subdural haematomas following lumbar puncture. Eur Neurol 53:159–160PubMedCrossRefGoogle Scholar
  127. 127.
    Lee AC, Lau Y, Li CH et al (2007) Intraspinal and intracranial hemorrhage after lumbar puncture. Pediatr Blood Cancer 48:233–237PubMedCrossRefGoogle Scholar
  128. 128.
    Openshaw H, Ressler JA, Snyder DS (2008) Lumbar puncture and subdural hygroma and hematomas in hematopoietic cell transplant patients. Bone Marrow Transplant 41:791–795PubMedCrossRefGoogle Scholar
  129. 129.
    Brown MW, Yilmaz TS, Kasper EM (2016) Iatrogenic spinal hematoma as a complication of lumbar puncture: what is the risk and best management plan? Surg Neurol Int 7:S581–S589PubMedPubMedCentralCrossRefGoogle Scholar
  130. 130.
    Talbert DG (2005) Paroxysmal cough injury, vascular rupture and 'shaken baby syndrome'. Med Hypotheses 64:8–13PubMedCrossRefGoogle Scholar
  131. 131.
    Geddes JF, Talbert DG (2006) Paroxysmal coughing, subdural and retinal bleeding: a computer modelling approach. Neuropathol Appl Neurobiol 32:625–634PubMedCrossRefGoogle Scholar
  132. 132.
    Watts CC, Acosta C (1969) Pertussis and bilateral subdural hematomas. Am J Dis Child 118:518–519PubMedGoogle Scholar
  133. 133.
    Curcoy AI, Trenchs V, Morales M et al (2012) Is pertussis in infants a potential cause of retinal haemorrhages? Arch Dis Child 97:239–240PubMedCrossRefGoogle Scholar
  134. 134.
    Raoof N, Pereira S, Dai S et al (2017) Retinal haemorrhage in infants with pertussis. Arch Dis Child 102:1158–1160PubMedCrossRefGoogle Scholar
  135. 135.
    Barnes PD, Galaznik J, Gardner H, Shuman M (2010) Infant acute life-threatening event --dysphagic choking versus nonaccidental injury. Semin Pediatr Neurol 17:7–11Google Scholar
  136. 136.
    Barnes PD (2011) Imaging of nonaccidental injury and the mimics: issues and controversies in the era of evidence-based medicine. Radiol Clin N Am 49:205–229PubMedCrossRefGoogle Scholar
  137. 137.
    Greeley CS (2010) Infant fatality. Semin Pediatr Neurol 17:275–278PubMedCrossRefGoogle Scholar
  138. 138.
    Edwards GA (2015) Mimics of child abuse: can choking explain abusive head trauma? J Forensic Legal Med 35:33–37CrossRefGoogle Scholar
  139. 139.
    Curcoy AI, Trenchs V, Morales M et al (2010) Retinal hemorrhages and apparent life-threatening events. Pediatr Emerg Care 26:118–120PubMedCrossRefGoogle Scholar
  140. 140.
    Bonkowsky JL, Guenther E, Filloux FM et al (2008) Death, child abuse and adverse neurological outcome of infants after an apparent life-threatening event. Pediatrics 122:125–131PubMedCrossRefGoogle Scholar
  141. 141.
    Hansen JB, Frazier T, Moffatt M et al (2017) Evaluation of the hypothesis that choking/ALTE may mimic abusive head trauma. Acad Pediatr 17:362–367PubMedCrossRefGoogle Scholar
  142. 142.
    Herr S, Pierce MC, Berger RP et al (2004) Does valsalva retinopathy occur in infants? An initial investigation in infants with vomiting caused by pyloric stenosis. Pediatrics 113:1658–1661PubMedCrossRefGoogle Scholar
  143. 143.
    Geddes JF, Tasker RC, Hackshaw AK et al (2003) Dural haemorrhage in non-traumatic infant deaths: does it explain the bleeding in 'shaken baby syndrome'? Neuropathol Appl Neurobiol 29:14–22PubMedCrossRefGoogle Scholar
  144. 144.
    Cohen MC, Scheimberg I (2009) Evidence of occurrence of intradural and subdural hemorrhage in the perinatal and neonatal period in the context of hypoxic ischemic encephalopathy: an observational study from two referral institutions in the United Kingdom. Pediatr Dev Pathol 12:169–176PubMedCrossRefGoogle Scholar
  145. 145.
    Punt J, Bonshek RE, Jaspan T et al (2004) The 'unified hypothesis' of Geddes et al. is not supported by the data. Pediatr Rehabil 7:173–184PubMedCrossRefGoogle Scholar
  146. 146.
    Rao P, Carty H, Pierce A (1999) The acute reversal sign: comparison of medical and non-accidental injury patients. Clin Radiol 54:495–501PubMedCrossRefGoogle Scholar
  147. 147.
    Byard RW, Blumbergs P, Rutty G et al (2007) Lack of evidence for a causal relationship between hypoxic-ischemic encephalopathy and subdural hemorrhage in fetal life, infancy and early childhood. Pediatr Dev Pathol 10:348–350PubMedCrossRefGoogle Scholar
  148. 148.
    Hurley M, Dineen R, Padfield CJH et al (2010) Is there a causal relationship between the hypoxia-ischaemia associated with cardiorespiratory arrest and subdural haematomas? An observational study. Br J Radiol 83:736–743PubMedPubMedCentralCrossRefGoogle Scholar
  149. 149.
    Bailey OT, Hass GM (1937) Dural sinus thrombosis in early life: recovery from acute thrombosis of the superior longitudinal sinus and its relation to certain acquired cerebral lesions in childhood. Brain 60:293–314CrossRefGoogle Scholar
  150. 150.
    Matsuda M, Matsuda I, Sato M et al (1982) Superior sagittal sinus thrombosis followed by subdural hematoma. Surg Neurol 18:206–211PubMedCrossRefGoogle Scholar
  151. 151.
    Bucy PC, Lesemann FJ (1942) Idiopathic recurrent thrombophlebitis: with cerebral venous thromboses and an acute subdural hematoma. JAMA 119:402–405CrossRefGoogle Scholar
  152. 152.
    Hedlund GL (2013) Cerebral sinovenous thrombosis in pediatric practice. Pediatr Radiol 43:173–188PubMedCrossRefGoogle Scholar
  153. 153.
    Sebire G, Tabarki B, Saunders DE et al (2005) Cerebral venous sinus thrombosis in children: risk factors, presentation, diagnosis and outcome. Brain 128:477–489PubMedCrossRefGoogle Scholar
  154. 154.
    Bracken J, Barnacle A, Ditchfield M (2013) Potential pitfalls in imaging of paediatric cerebral sinovenous thrombosis. Pediatr Radiol 43:219–231PubMedCrossRefGoogle Scholar
  155. 155.
    Heller C, Heinecke A, Junker R et al (2003) Cerebral venous thrombosis in children: a multifactorial origin. Circulation 108:1362–1367PubMedCrossRefGoogle Scholar
  156. 156.
    deVeber G, Andrew M, Adams C et al (2001) Cerebral sinovenous thrombosis in children. N Engl J Med 345:417–423PubMedCrossRefGoogle Scholar
  157. 157.
    McLean LA, Frasier LD, Hedlund GL (2012) Does intracranial venous thrombosis cause subdural hemorrhage in the pediatric population? AJNR Am J Neuroradiol 33:1281–1284PubMedCrossRefGoogle Scholar
  158. 158.
    Wilms G, Vanderschueren G, Demaerel PH et al (1993) CT and MR in infants with pericerebral collections and macrocephaly: benign enlargement of the subarachnoid spaces versus subdural collections. AJNR Am J Neuroradiol 14:855–860PubMedGoogle Scholar
  159. 159.
    McKeag H, Christian CW, Rubin D et al (2013) Subdural hemorrhage in pediatric patients with enlargement of the subarachnoid spaces. J Neurosurg Pediatr 11:438–444PubMedCrossRefGoogle Scholar
  160. 160.
    Tucker J, Choudhary AK, Piatt J (2016) Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections. J Neurosurg Pediatr 18:16–20PubMedCrossRefGoogle Scholar
  161. 161.
    Greiner MV, Richards TJ, Care MM et al (2013) Prevalence of subdural collections in children with macrocrania. AJNR Am J Neuroradiol 34:2373–2378PubMedCrossRefGoogle Scholar
  162. 162.
    McNeely PD, Atkinson JD, Saigal G et al (2006) Subdural hematomas in infants with benign enlargement of the subarachnoid spaces are not pathognomonic for child abuse. AJNR Am J Neuroradiol 27:1725–1728PubMedGoogle Scholar
  163. 163.
    Haws ME, Linscott L, Thomas C et al (2017) A retrospective analysis of the utility of head computed tomography and/or magnetic resonance imaging in the management of benign macrocrania. J Pediatr 182:283–289PubMedCrossRefGoogle Scholar
  164. 164.
    Alper G, Ekinci G, Yilmaz Y et al (1999) Magnetic resonance imaging characteristics of benign macrocephaly in children. J Child Neurol 14:678–682PubMedCrossRefGoogle Scholar
  165. 165.
    Hansen JB, Frazier T, Moffatt M et al (2018) Evaluations for abuse in young children with subdural hemorrhages: findings based on symptom severity and benign enlargement of the subarachnoid spaces. J Neurosurg Pediatr 21:31–37PubMedCrossRefGoogle Scholar
  166. 166.
    Towner D, Castro MA, Eby-Wilkens E et al (1999) Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 341:1709–1714PubMedCrossRefGoogle Scholar
  167. 167.
    Abroms IF, McLennan JE, Mandell F (1977) Acute neonatal subdural hematoma following breech delivery. Am J Dis Child 131:192–194PubMedGoogle Scholar
  168. 168.
    Bergman I, Bauer RE, Barmada MA et al (1985) Intracerebral hemorrhage in the full-term neonatal infant. Pediatrics 75:488–496PubMedCrossRefGoogle Scholar
  169. 169.
    Gresham EL (1975) Birth trauma. Pediatr Clin N Am 22:317–328CrossRefGoogle Scholar
  170. 170.
    Hanigan WC, Morgan AM, Stahlberg LK et al (1990) Tentorial hemorrhage associated with vacuum extraction. Pediatrics 85:534–539PubMedGoogle Scholar
  171. 171.
    Hernansanz J, Munoz F, Rodriguez D et al (1984) Subdural hematomas of the posterior fossa in normal-weight newborns. Report of two cases. J Neurosurg 61:972–974PubMedCrossRefGoogle Scholar
  172. 172.
    Hickey K, McKenna P (1996) Skull fracture caused by vacuum extraction. Obstet Gynecol 88:671–673PubMedCrossRefGoogle Scholar
  173. 173.
    Hill A, Martin DJ, Daneman A et al (1983) Focal ischemic cerebral injury in the newborn: diagnosis by ultrasound and correlation with computed tomographic scan. Pediatrics 71:790–793PubMedGoogle Scholar
  174. 174.
    Hovind KH (1986) Traumatic birth injuries. In: Raimondi AJ, Choux M, Di Rocco C (eds) Head injuries in the newborn and infant. Springer, New York, pp 87–109CrossRefGoogle Scholar
  175. 175.
    Leblanc R, O'Gorman AM (1980) Neonatal intracranial hemorrhage. A clinical and serial computerized tomographic study. J Neurosurg 53:642–651PubMedCrossRefGoogle Scholar
  176. 176.
    Mannino FL, Trauner DA (1983) Stroke in neonates. J Pediatr 102:605–610PubMedCrossRefGoogle Scholar
  177. 177.
    Menezes AH, Smith DE, Bell WE (1983) Posterior fossa hemorrhage in the term neonate. Neurosurgery 13:452–456PubMedCrossRefGoogle Scholar
  178. 178.
    Natelson SE, Sayers MP (1973) The fate of children sustaining severe head trauma during birth. Pediatrics 51:169–174PubMedGoogle Scholar
  179. 179.
    Perrin RG, Rutka JT, Drake JM et al (1997) Management and outcomes of posterior fossa subdural hematomas in neonates. Neurosurgery 40:1190–1199PubMedCrossRefGoogle Scholar
  180. 180.
    Pollina J, Dias MS, Li V et al (2001) Cranial birth injuries in term newborn infants. Pediatr Neurosurg 35:113–119PubMedCrossRefGoogle Scholar
  181. 181.
    Ravenel SD (1979) Posterior fossa hemorrhage in the term newborn: report of two cases. Pediatrics 64:39–42PubMedGoogle Scholar
  182. 182.
    Roessmann U, Miller RT (1980) Thrombosis of the middle cerebral artery associated with birth trauma. Neurology 30:889–892PubMedCrossRefGoogle Scholar
  183. 183.
    Romodanov AP, Brodsky Yu S (1987) Subdural hematomas in the newborn. Surgical treatment and results. Surg Neurol 28:253–258PubMedCrossRefGoogle Scholar
  184. 184.
    Takagi T, Fukuoka H, Wakabayashi S et al (1982) Posterior fossa subdural hemorrhage in the newborn as a result of birth trauma. Childs Brain 9:102–113PubMedGoogle Scholar
  185. 185.
    Looney CB, Smith JK, Merck LH et al (2007) Intracranial hemorrhage in asymptomatic neonates: prevalence on MR images and relationship to obstetric and neonatal risk factors. Radiology 242:535–541PubMedCrossRefGoogle Scholar
  186. 186.
    Rooks VJ, Eaton JP, Ruess L et al (2008) Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants. AJNR Am J Neuroradiol 29:1082–1089PubMedCrossRefGoogle Scholar
  187. 187.
    Whitby EH, Griffiths PD, Rutter S et al (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846–851PubMedCrossRefGoogle Scholar
  188. 188.
    Uscinski RH, McBride DK (2008) The shaken baby syndrome: an odyssey. II Origins and further hypotheses. Neurol Med Chir 48:151–155CrossRefGoogle Scholar
  189. 189.
    Holden KR, Titus MO, Van Tassel P (1999) Cranial magnetic resonance imaging examination of normal term neonates: a pilot study. J Child Neurol 14:708–710PubMedCrossRefGoogle Scholar
  190. 190.
    Kolbo JR, Strong E (1997) Multidisciplinary team approaches to the investigation and resolution of child abuse and neglect: a national survey. Child Maltreat 2:61–72CrossRefGoogle Scholar
  191. 191.
    Palusci VJ, Covington TM (2014) Child maltreatment deaths in the U.S. National Child Death Review Case Reporting System. Child Abuse Negl 38:25–36PubMedCrossRefGoogle Scholar
  192. 192.
    Schnitzer PG, Ewigman BG (2005) Child deaths resulting from inflicted injuries: household risk factors and perpetrator characteristics. Pediatrics 116:e687–e693PubMedPubMedCentralCrossRefGoogle Scholar
  193. 193.
    Spies EL, Klevens J (2016) Fatal abusive head trauma among children aged <5 years — United States, 1999–2014. MMWR Morb Mortal Wkly Rep 65:505–509PubMedCrossRefGoogle Scholar
  194. 194.
    U. S. Department of Health and Human Services; Administration for Children and Families; Administration on Children, Youth and Families; Children’s Bureau (2018) Child maltreatment 2016. Accessed 29 March 2018
  195. 195.
    Palusci VJ, Smith EG, Paneth N (2005) Predicting and responding to physical abuse in young children using NCANDS. Child Youth Serv Rev 27:667–682CrossRefGoogle Scholar
  196. 196.
    Chevignard MP, Lind K (2014) Long-term outcome of abusive head trauma. Pediatr Radiol 44:S548–S558PubMedCrossRefGoogle Scholar
  197. 197.
    Miller TR, Steinbeigle R, Lawrence BA et al (2017) Lifetime cost of abusive head trauma at ages 0–4, USA. Prev Sci.
  198. 198.
    Paul SR, Narang SK, Committee on Medical Liability and Risk Management (2017) Expert witness participation in civil and criminal proceedings. Pediatrics 139(3)Google Scholar
  199. 199.
    Chadwick DL, Krous HF (1997) Irresponsible testimony by medical experts in cases involving the physical abuse and neglect of children. Child Maltreat 2:313–321CrossRefGoogle Scholar
  200. 200.
    Whiting P, Rutjes AW, Reitsma JB et al (2003) The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3:25PubMedPubMedCentralCrossRefGoogle Scholar
  201. 201.
    Donohoe M (2003) Evidence-based medicine and shaken baby syndrome: part I: literature review, 1966-1998. Am J Forensic Med Pathol 24:239–242PubMedCrossRefGoogle Scholar
  202. 202.
    Lynoe N, Elinder G, Hallberg B et al (2017) Insufficient evidence for 'shaken baby syndrome' — a systematic review. Acta Paediatr 106:1021–1027PubMedCrossRefGoogle Scholar
  203. 203.
    Narang SK, Greeley CS (2017) Lynoe et al.- #theRestoftheStory. Acta Paediatr 106:1047–1049PubMedCrossRefGoogle Scholar
  204. 204.
    Greeley CS (2015) Abusive head trauma: a review of the evidence base. AJR Am J Roentgenol 204:967–973PubMedCrossRefGoogle Scholar
  205. 205.
    Hill AB (1965) The environment and disease: association or causation? Proc R Soc Med 58:295–300PubMedPubMedCentralGoogle Scholar
  206. 206.
    Bilo RAC, Banaschak S, Herrmann B et al (2017) Using the table in the Swedish review on shaken baby syndrome will not help courts deliver justice. Acta Paediatr 106:1043–1045PubMedCrossRefGoogle Scholar
  207. 207.
    Hellgren K, Hellstrom A, Hard AL et al (2017) The new Swedish report on shaken baby syndrome is misleading. Acta Paediatr 106:1040PubMedCrossRefGoogle Scholar
  208. 208.
    Lucas S, Bärtås A, Bonamy A-KE et al (2017) The way forward in addressing abusive head trauma in infants — current perspectives from Sweden. Acta Paediatr 106:1033–1035PubMedCrossRefGoogle Scholar
  209. 209.
    Levin AV (2017) The SBU report: a different view. Acta Paediatr 106:1037–1039PubMedCrossRefGoogle Scholar
  210. 210.
    Saunders D, Raissaki M, Servaes S et al (2017) Throwing the baby out with the bath water — response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking. Pediatr Radiol 47:1386–1389PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Arabinda Kumar Choudhary
    • 1
    Email author
  • Sabah Servaes
    • 2
  • Thomas L. Slovis
    • 3
  • Vincent J. Palusci
    • 4
  • Gary L. Hedlund
    • 5
  • Sandeep K. Narang
    • 6
  • Joëlle Anne Moreno
    • 7
  • Mark S. Dias
    • 8
  • Cindy W. Christian
    • 9
  • Marvin D. NelsonJr
    • 10
  • V. Michelle Silvera
    • 11
  • Susan Palasis
    • 12
  • Maria Raissaki
    • 13
  • Andrea Rossi
    • 14
  • Amaka C. Offiah
    • 15
  1. 1.Department of RadiologyNemours AI duPont Hospital for ChildrenWilmingtonUSA
  2. 2.Department of Radiology, The Children’s Hospital of PhiladelphiaUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of Radiology, Children’s Hospital of MichiganWayne State UniversityDetroitUSA
  4. 4.New York University School of MedicineNew YorkUSA
  5. 5.Department of Medical Imaging, Primary Children’s Hospital, Intermountain Healthcare, Department of RadiologyUniversity of Utah School of MedicineSalt Lake CityUSA
  6. 6.Division of Child Abuse PediatricsAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  7. 7.Florida International University College of LawMiamiUSA
  8. 8.Departments of Neurosurgery and PediatricsPenn State Health Children’s HospitalHersheyUSA
  9. 9.Department of Pediatrics, Child Abuse and Neglect Prevention, The Children’s Hospital of PhiladelphiaThe Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  10. 10.Department of RadiologyChildren’s Hospital of Los AngelesLos AngelesUSA
  11. 11.Department of RadiologyBoston Children’s HospitalBostonUSA
  12. 12.Pediatric Neuroradiology, Children’s Healthcare of Atlanta, Scottish Rite Campus, Department of RadiologyEmory University School of MedicineAtlantaUSA
  13. 13.Department of RadiologyUniversity Hospital of Heraklion, University of CreteCreteGreece
  14. 14.Neuroradiology UnitIstituto Giannina GasliniGenoaItaly
  15. 15.Paediatric Musculoskeletal Imaging, Academic Unit of Child Health, Sheffield Children’s NHS Foundation Trust, Western BankUniversity of SheffieldSheffieldUK

Personalised recommendations