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Imaging of Nonaccidental Head Injury

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Evidence-Based Imaging in Pediatrics

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Key Points

■ Head injury is the most common cause of death from nonaccidental trauma, and the majority of NAHI occurs in infants under age 1 year; its clinical presentation is nonspecific (moderate evidence).

■ NAHI is suspected when the magnitude of the injury demonstrated clinically or on neuroimaging is discrepant with the history provided (moderate evidence).

■ Subdural hematoma is the most commonly associated pathology with NAHI (moderate evidence).

■ None of the intracranial pathology is specific or pathognomonic for NAHI.

■ Temporal evolution of subdural hematoma associated with NAHI is dynamic and complex. For the best estimation of injury timing, comparison of CT and MRI and correlation with follow-up studies are often needed.

■ CT is the standard of care for the initial evaluation of NAHI. CT readily demonstrates intracranial pathology requiring immediate treatment (moderate evidence).

■ MRI should be performed once the patient is stabilized. Overall, MRI is more sensitive than CT for diagnosis, documentation, characterization, and prognostication of intracranial pathology associated with NAHI (limited evidence).

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Authors and Affiliations

  1. Department of Radiology, University of Iowa, 52242, Iowa City, IA, USA

    Yutaka Sato

  2. Department of Radiology, University of Iowa Hospitals and Clinics, 52242, Iowa City, IA, USA

    Toshio Moritani MD, PhD (Assistant Professor)

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  1. Yutaka Sato
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Correspondence to Yutaka Sato .

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Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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Sato, Y., Moritani, T. (2010). Imaging of Nonaccidental Head Injury. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_12

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