Imaging of Nonaccidental Head Injury

  • Yutaka Sato
  • Toshio Moritani

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).


Traumatic Brain Injury Child Abuse Diffusion Tensor Imaging Subdural Hematoma Epidural Hematoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Authors and Affiliations

  1. 1.Department of RadiologyUniversity of IowaIowa CityUSA
  2. 2.Department of RadiologyUniversity of Iowa Hospitals and ClinicsIowa CityUSA

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