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Spinal subdural hematomas in children with non accidental head injury
  1. Panos Koumellis (pkoumellis{at}yahoo.com)
  1. Queen's Medical Centre, Nottingham, United Kingdom
    1. Norman S McConachie (norman.mcconachie{at}nuh.nhs.uk)
    1. Queen's Medical Centre, Nottingham, United Kingdom
      1. Timothy Jaspan (tim.jaspan{at}nuh.nhs.uk)
      1. Queen's Medical Centre, Nottingham, United Kingdom

        Abstract

        Background and purpose: To examine the incidence of spinal pathology in infants with non accidental head injury.

        Methods: 18 infants with non-accidental injury (NAI) were investigated in our institution between 2000 and 2007 with dedicated MR imaging of the brain and the spine. During the earlier years the spine was imaged when there were suspicious features on other imaging to suggest a spinal injury (7 cases). Since 2005 we routinely investigate all suspected NAI cases with MRI of the whole spine in addition to the brain. The spinal imaging at initial investigation and at follow up was reviewed.

        Results: There was a high incidence (8/18 cases, 44%) of subdural collections in the spine. They were all clinically occult and in 6 cases large. All eight cases were associated with subdural haematomas (SDH) in the supra and infra-tentorial compartment. The signal characteristics were analysed and compared to those of the intracranial collections. One had a small epidural haematoma. Other depicted abnormalities and appearances at follow up were also reviewed.

        Conclusion: In our experience there is a high incidence of previously unsuspected spinal SDHs associated with intracranial collections in children with NAI. Further work is required to evaluate the clinical implications

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