Neuroimaging: what neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review
Objectives To identify the evidence base behind the neuroradiological features that differentiate abusive head trauma (AHT) from non-abusive head trauma (nAHT). Design Systematic review. Setting Literature search of 14 databases, websites, textbooks, conference abstracts and references (1970–Februar...
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description | Objectives To identify the evidence base behind the neuroradiological features that differentiate abusive head trauma (AHT) from non-abusive head trauma (nAHT). Design Systematic review. Setting Literature search of 14 databases, websites, textbooks, conference abstracts and references (1970–February 2010). Studies had two independent reviews (three if disputed) and critical appraisal. Patients Primary comparative studies of children |
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A systematic review</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Kemp, A M ; Jaspan, T ; Griffiths, J ; Stoodley, N ; Mann, M K ; Tempest, V ; Maguire, S A</creator><creatorcontrib>Kemp, A M ; Jaspan, T ; Griffiths, J ; Stoodley, N ; Mann, M K ; Tempest, V ; Maguire, S A</creatorcontrib><description>Objectives To identify the evidence base behind the neuroradiological features that differentiate abusive head trauma (AHT) from non-abusive head trauma (nAHT). Design Systematic review. Setting Literature search of 14 databases, websites, textbooks, conference abstracts and references (1970–February 2010). Studies had two independent reviews (three if disputed) and critical appraisal. Patients Primary comparative studies of children <11 years old hospitalised with AHT and nAHT diagnosed on CT or MRI. Main outcome measures Neuroradiological features that differentiated AHT from nAHT. Results 21 studies of children predominantly <3 years old were analysed. Subdural haemorrhages (SDH) were significantly associated with AHT (OR 8.2, 95% CI 6.1 to 11). Subarachnoid haemorrhages were seen equally in AHT and nAHT and extradural haemorrhages (EDH) were significantly associated with nAHT (OR for AHT 0.1, 95% CI 0.07 to 0.18). Multiple (OR 6, 95% CI 2.5 to 14.4), interhemispheric (OR 7.9, 95% CI 4.7 to 13), convexity (OR 4.9, 95% CI 1.3 to 19.4) and posterior fossa haemorrhages (OR 2.5, 95% CI 1 to 6) were associated with AHT. Hypoxic-ischaemic injury (HII) (OR 3.7, 95% CI 1.4 to 10) and cerebral oedema (OR 2.2, 95% CI 1.0 to 4.5) were significantly associated with AHT, while focal parenchymal injury was not a discriminatory feature. SDH of low attenuation were more common in AHT than in nAHT. Conclusion Multiple SDH over the convexity, interhemispheric haemorrhages, posterior fossa SDH, HII and cerebral oedema are significantly associated with AHT and should be considered together with clinical features when identifying the condition.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2011-300630</identifier><identifier>PMID: 21965812</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Biological and medical sciences ; Brain Edema - diagnosis ; Brain Edema - etiology ; Child ; Child Abuse ; Child abuse & neglect ; Child Abuse - diagnosis ; Child Neglect ; Child Safety ; Child, Preschool ; Children & youth ; Comparative Analysis ; Comparative studies ; Craniocerebral Trauma - etiology ; Diagnosis, Differential ; Diagnostic Tests ; Edema ; Evidence ; Evidence-Based Medicine - methods ; General aspects ; Head injuries ; Hemorrhage ; Humans ; Hypoxia ; Infant ; Infant, Newborn ; Information Seeking ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Intracranial Hemorrhages - diagnosis ; Intracranial Hemorrhages - etiology ; Ischemia ; Magnetic Resonance Imaging ; Medical imaging ; Medical sciences ; Meta Analysis ; Miscellaneous ; Neuroimaging ; Neurology ; Ophthalmology ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Search Strategies ; Systematic review ; Tomography, X-Ray Computed ; Trauma ; Traumas. Diseases due to physical agents ; Young Children</subject><ispartof>Archives of disease in childhood, 2011-12, Vol.96 (12), p.1103-1112</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b520t-518b1fe3acd941c363332074f556f29b44aa7d59449bf646177f969540f74a3a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://adc.bmj.com/content/96/12/1103.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://adc.bmj.com/content/96/12/1103.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77569,77600</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24770719$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21965812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kemp, A M</creatorcontrib><creatorcontrib>Jaspan, T</creatorcontrib><creatorcontrib>Griffiths, J</creatorcontrib><creatorcontrib>Stoodley, N</creatorcontrib><creatorcontrib>Mann, M K</creatorcontrib><creatorcontrib>Tempest, V</creatorcontrib><creatorcontrib>Maguire, S A</creatorcontrib><title>Neuroimaging: what neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>Objectives To identify the evidence base behind the neuroradiological features that differentiate abusive head trauma (AHT) from non-abusive head trauma (nAHT). Design Systematic review. Setting Literature search of 14 databases, websites, textbooks, conference abstracts and references (1970–February 2010). Studies had two independent reviews (three if disputed) and critical appraisal. Patients Primary comparative studies of children <11 years old hospitalised with AHT and nAHT diagnosed on CT or MRI. Main outcome measures Neuroradiological features that differentiated AHT from nAHT. Results 21 studies of children predominantly <3 years old were analysed. Subdural haemorrhages (SDH) were significantly associated with AHT (OR 8.2, 95% CI 6.1 to 11). Subarachnoid haemorrhages were seen equally in AHT and nAHT and extradural haemorrhages (EDH) were significantly associated with nAHT (OR for AHT 0.1, 95% CI 0.07 to 0.18). Multiple (OR 6, 95% CI 2.5 to 14.4), interhemispheric (OR 7.9, 95% CI 4.7 to 13), convexity (OR 4.9, 95% CI 1.3 to 19.4) and posterior fossa haemorrhages (OR 2.5, 95% CI 1 to 6) were associated with AHT. Hypoxic-ischaemic injury (HII) (OR 3.7, 95% CI 1.4 to 10) and cerebral oedema (OR 2.2, 95% CI 1.0 to 4.5) were significantly associated with AHT, while focal parenchymal injury was not a discriminatory feature. SDH of low attenuation were more common in AHT than in nAHT. Conclusion Multiple SDH over the convexity, interhemispheric haemorrhages, posterior fossa SDH, HII and cerebral oedema are significantly associated with AHT and should be considered together with clinical features when identifying the condition.</description><subject>Biological and medical sciences</subject><subject>Brain Edema - diagnosis</subject><subject>Brain Edema - etiology</subject><subject>Child</subject><subject>Child Abuse</subject><subject>Child abuse & neglect</subject><subject>Child Abuse - diagnosis</subject><subject>Child Neglect</subject><subject>Child Safety</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Comparative Analysis</subject><subject>Comparative studies</subject><subject>Craniocerebral Trauma - etiology</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic Tests</subject><subject>Edema</subject><subject>Evidence</subject><subject>Evidence-Based Medicine - methods</subject><subject>General aspects</subject><subject>Head injuries</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Information Seeking</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Intracranial Hemorrhages - diagnosis</subject><subject>Intracranial Hemorrhages - etiology</subject><subject>Ischemia</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Meta Analysis</subject><subject>Miscellaneous</subject><subject>Neuroimaging</subject><subject>Neurology</subject><subject>Ophthalmology</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Search Strategies</subject><subject>Systematic review</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Traumas. 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A systematic review</title><author>Kemp, A M ; Jaspan, T ; Griffiths, J ; Stoodley, N ; Mann, M K ; Tempest, V ; Maguire, S A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b520t-518b1fe3acd941c363332074f556f29b44aa7d59449bf646177f969540f74a3a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Biological and medical sciences</topic><topic>Brain Edema - diagnosis</topic><topic>Brain Edema - etiology</topic><topic>Child</topic><topic>Child Abuse</topic><topic>Child abuse & neglect</topic><topic>Child Abuse - diagnosis</topic><topic>Child Neglect</topic><topic>Child Safety</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Comparative Analysis</topic><topic>Comparative studies</topic><topic>Craniocerebral Trauma - etiology</topic><topic>Diagnosis, Differential</topic><topic>Diagnostic Tests</topic><topic>Edema</topic><topic>Evidence</topic><topic>Evidence-Based Medicine - methods</topic><topic>General aspects</topic><topic>Head injuries</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Information Seeking</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Intracranial Hemorrhages - diagnosis</topic><topic>Intracranial Hemorrhages - etiology</topic><topic>Ischemia</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Meta Analysis</topic><topic>Miscellaneous</topic><topic>Neuroimaging</topic><topic>Neurology</topic><topic>Ophthalmology</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Search Strategies</topic><topic>Systematic review</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Traumas. 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A systematic review</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>96</volume><issue>12</issue><spage>1103</spage><epage>1112</epage><pages>1103-1112</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>Objectives To identify the evidence base behind the neuroradiological features that differentiate abusive head trauma (AHT) from non-abusive head trauma (nAHT). Design Systematic review. Setting Literature search of 14 databases, websites, textbooks, conference abstracts and references (1970–February 2010). Studies had two independent reviews (three if disputed) and critical appraisal. Patients Primary comparative studies of children <11 years old hospitalised with AHT and nAHT diagnosed on CT or MRI. Main outcome measures Neuroradiological features that differentiated AHT from nAHT. Results 21 studies of children predominantly <3 years old were analysed. Subdural haemorrhages (SDH) were significantly associated with AHT (OR 8.2, 95% CI 6.1 to 11). Subarachnoid haemorrhages were seen equally in AHT and nAHT and extradural haemorrhages (EDH) were significantly associated with nAHT (OR for AHT 0.1, 95% CI 0.07 to 0.18). Multiple (OR 6, 95% CI 2.5 to 14.4), interhemispheric (OR 7.9, 95% CI 4.7 to 13), convexity (OR 4.9, 95% CI 1.3 to 19.4) and posterior fossa haemorrhages (OR 2.5, 95% CI 1 to 6) were associated with AHT. Hypoxic-ischaemic injury (HII) (OR 3.7, 95% CI 1.4 to 10) and cerebral oedema (OR 2.2, 95% CI 1.0 to 4.5) were significantly associated with AHT, while focal parenchymal injury was not a discriminatory feature. SDH of low attenuation were more common in AHT than in nAHT. Conclusion Multiple SDH over the convexity, interhemispheric haemorrhages, posterior fossa SDH, HII and cerebral oedema are significantly associated with AHT and should be considered together with clinical features when identifying the condition.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><pmid>21965812</pmid><doi>10.1136/archdischild-2011-300630</doi><tpages>10</tpages></addata></record> |
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subjects | Biological and medical sciences Brain Edema - diagnosis Brain Edema - etiology Child Child Abuse Child abuse & neglect Child Abuse - diagnosis Child Neglect Child Safety Child, Preschool Children & youth Comparative Analysis Comparative studies Craniocerebral Trauma - etiology Diagnosis, Differential Diagnostic Tests Edema Evidence Evidence-Based Medicine - methods General aspects Head injuries Hemorrhage Humans Hypoxia Infant Infant, Newborn Information Seeking Injuries of the nervous system and the skull. Diseases due to physical agents Intracranial Hemorrhages - diagnosis Intracranial Hemorrhages - etiology Ischemia Magnetic Resonance Imaging Medical imaging Medical sciences Meta Analysis Miscellaneous Neuroimaging Neurology Ophthalmology Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Search Strategies Systematic review Tomography, X-Ray Computed Trauma Traumas. Diseases due to physical agents Young Children |
title | Neuroimaging: what neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review |
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