Department of Radiology, University of Arkansas for Medical Sciences, 4301 W. Markham St., Slot 556, Little Rock, AR, 72205, USA.
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Pediatr Radiol. 2021 May;51(6):918-926. doi: 10.1007/s00247-021-05016-9. Epub 2021 Apr 21.
Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. An intracranial pathology can exist even in the setting of a normal physical exam. A delay in the diagnosis of AHT can have serious life-threatening consequences for the child and increases the potential the child will be abused again. In this article, we review the traumatic subdural hematoma as well as various morpho-structural patterns of shearing injuries and thrombosis of intracranial bridging veins. This work serves as a summary of patterns of imaging features of intracranial venous injury in AHT, as described in the literature, to facilitate familiarity and early detection of abusive head trauma in the pediatric population. Essentially, in AHT there is a traumatic injury to the bridging vein with either partial or complete tear. This can secondarily result in thrombosis at the terminal end of the bridging vein with blood clots adjacent to the bridging vein.
虐待性头部外伤(AHT)是 2 岁以下儿童致命性头部损伤的主要原因。即使在体格检查正常的情况下,也可能存在颅内病变。AHT 的诊断延迟会对儿童造成严重的生命威胁,并增加儿童再次受到虐待的可能性。在本文中,我们回顾了外伤性硬膜下血肿以及各种剪切伤的形态结构模式和颅内桥静脉血栓形成。这项工作总结了文献中描述的 AHT 中颅内静脉损伤的影像学特征模式,以促进在儿科人群中熟悉和早期发现虐待性头部外伤。从本质上讲,在 AHT 中,桥静脉会受到创伤性损伤,导致部分或完全撕裂。这可能会导致桥静脉末端血栓形成,血栓紧邻桥静脉。