Subdural hygromas in abusive head trauma: pathogenesis, diagnosis, and forensic implications

Are subdural hygromas the result of abusive head trauma? CT and MR imaging represent important tools for the diagnosis of abusive head trauma in living infants. In addition, in-depth understanding of the pathogenesis of subdural hygromas is increasingly required by neuroradiologists, pediatricians,...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2015-03, Vol.36 (3), p.432-439
Main Authors: Wittschieber, D, Karger, B, Niederstadt, T, Pfeiffer, H, Hahnemann, M L
Format: Article
Language:English
Subjects:
Child Abuse
Craniocerebral Trauma - complications
Craniocerebral Trauma - diagnosis
Forensic Medicine - methods
Hematoma, Subdural, Chronic - diagnosis
Hematoma, Subdural, Chronic - etiology
Humans
Infant
Male
Review
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Summary:Are subdural hygromas the result of abusive head trauma? CT and MR imaging represent important tools for the diagnosis of abusive head trauma in living infants. In addition, in-depth understanding of the pathogenesis of subdural hygromas is increasingly required by neuroradiologists, pediatricians, and forensic physicians. Therefore, the current knowledge on subdural hygromas is summarized and forensic conclusions are drawn. The most important diagnostic pitfalls, benign enlargement of the subarachnoid space, and chronic subdural hematoma, are discussed in detail. Illustrative cases from forensic practice are presented. Literature analysis indicates that subdural hygromas can occur immediately or be delayed. If other infrequent reasons can be excluded, the presence of subdural hygromas strongly suggests a posttraumatic state and should prompt the physician to search for other signs of abuse. To differentiate subdural hygromas from other pathologies, additional MR imaging of the infant's head is indispensable after initial CT scan.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A3989