Valeria Della Valle, Saskia Vande Perre, Nathalie de Suremain, Solène Loschi, Catherine Adamsbaum, Catherine Garel
{"title":"婴儿低速意外头部外伤后颅脑损伤的计算机断层扫描特征是什么？","authors":"Valeria Della Valle, Saskia Vande Perre, Nathalie de Suremain, Solène Loschi, Catherine Adamsbaum, Catherine Garel","doi":"10.1007/s00247-025-06348-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Differentiating accidental head trauma and abusive head trauma (AHT) may be challenging in infants.</p><p><strong>Objective: </strong>To describe computed tomography (CT) scan findings following accidental low-velocity trauma in infants, focusing on features considered to be highly suggestive of AHT, such as rupture of bridging veins.</p><p><strong>Materials and methods: </strong>A single-center, retrospective study (2014-2022) was performed in infants aged 1 month to 12 months.</p><p><strong>Inclusion criteria: </strong>(i) any kind of minor head trauma leading to an Emergency Department visit (fall from a height of less than 2 m, direct head impact, low-velocity road accident (below 15 km/h); (ii) available clinical data and head CT scan.</p><p><strong>Results: </strong>Three hundred and six infants were included (mean age 5 months 14 days, 56.5% male). Fractures were observed in 89 patients (71 simple linear fractures). Intracranial hemorrhage was observed in 34 patients: simple post-traumatic focal extra-axial hemorrhage in 26 patients and more complex hemorrhage on CT and magnetic resonance imaging in eight patients, including three with evidence of bridging vein rupture. Among these cases, the child protection team expressed concern that two patients might have experienced AHT, while the third patient had a condylar fracture and it remains unclear whether the injury was the result of AHT or an accidental fall. A significant link was found between intracranial hemorrhage and fractures (P-value < 0.001), scalp swelling (P-value < 0.001), or clots located at the vertex (P-value < 0.001) and between fractures and scalp swelling (P-value < 0.001), the trauma mechanism (P-value < 0.001), neurological symptoms (P-value = 0.03), and intracranial hemorrhage (P-value < 0.001).</p><p><strong>Conclusion: </strong>The main CT scan features following minor accidental trauma in infants are simple skull fractures and scalp swelling. Diffuse hemorrhage with rupture of bridging veins is exceptional in this context.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"What are the computed tomography patterns of head injury following low-velocity accidental head trauma in infants?\",\"authors\":\"Valeria Della Valle, Saskia Vande Perre, Nathalie de Suremain, Solène Loschi, Catherine Adamsbaum, Catherine Garel\",\"doi\":\"10.1007/s00247-025-06348-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Differentiating accidental head trauma and abusive head trauma (AHT) may be challenging in infants.</p><p><strong>Objective: </strong>To describe computed tomography (CT) scan findings following accidental low-velocity trauma in infants, focusing on features considered to be highly suggestive of AHT, such as rupture of bridging veins.</p><p><strong>Materials and methods: </strong>A single-center, retrospective study (2014-2022) was performed in infants aged 1 month to 12 months.</p><p><strong>Inclusion criteria: </strong>(i) any kind of minor head trauma leading to an Emergency Department visit (fall from a height of less than 2 m, direct head impact, low-velocity road accident (below 15 km/h); (ii) available clinical data and head CT scan.</p><p><strong>Results: </strong>Three hundred and six infants were included (mean age 5 months 14 days, 56.5% male). Fractures were observed in 89 patients (71 simple linear fractures). Intracranial hemorrhage was observed in 34 patients: simple post-traumatic focal extra-axial hemorrhage in 26 patients and more complex hemorrhage on CT and magnetic resonance imaging in eight patients, including three with evidence of bridging vein rupture. Among these cases, the child protection team expressed concern that two patients might have experienced AHT, while the third patient had a condylar fracture and it remains unclear whether the injury was the result of AHT or an accidental fall. A significant link was found between intracranial hemorrhage and fractures (P-value < 0.001), scalp swelling (P-value < 0.001), or clots located at the vertex (P-value < 0.001) and between fractures and scalp swelling (P-value < 0.001), the trauma mechanism (P-value < 0.001), neurological symptoms (P-value = 0.03), and intracranial hemorrhage (P-value < 0.001).</p><p><strong>Conclusion: </strong>The main CT scan features following minor accidental trauma in infants are simple skull fractures and scalp swelling. Diffuse hemorrhage with rupture of bridging veins is exceptional in this context.</p>\",\"PeriodicalId\":19755,\"journal\":{\"name\":\"Pediatric Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00247-025-06348-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00247-025-06348-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
What are the computed tomography patterns of head injury following low-velocity accidental head trauma in infants?
Background: Differentiating accidental head trauma and abusive head trauma (AHT) may be challenging in infants.
Objective: To describe computed tomography (CT) scan findings following accidental low-velocity trauma in infants, focusing on features considered to be highly suggestive of AHT, such as rupture of bridging veins.
Materials and methods: A single-center, retrospective study (2014-2022) was performed in infants aged 1 month to 12 months.
Inclusion criteria: (i) any kind of minor head trauma leading to an Emergency Department visit (fall from a height of less than 2 m, direct head impact, low-velocity road accident (below 15 km/h); (ii) available clinical data and head CT scan.
Results: Three hundred and six infants were included (mean age 5 months 14 days, 56.5% male). Fractures were observed in 89 patients (71 simple linear fractures). Intracranial hemorrhage was observed in 34 patients: simple post-traumatic focal extra-axial hemorrhage in 26 patients and more complex hemorrhage on CT and magnetic resonance imaging in eight patients, including three with evidence of bridging vein rupture. Among these cases, the child protection team expressed concern that two patients might have experienced AHT, while the third patient had a condylar fracture and it remains unclear whether the injury was the result of AHT or an accidental fall. A significant link was found between intracranial hemorrhage and fractures (P-value < 0.001), scalp swelling (P-value < 0.001), or clots located at the vertex (P-value < 0.001) and between fractures and scalp swelling (P-value < 0.001), the trauma mechanism (P-value < 0.001), neurological symptoms (P-value = 0.03), and intracranial hemorrhage (P-value < 0.001).
Conclusion: The main CT scan features following minor accidental trauma in infants are simple skull fractures and scalp swelling. Diffuse hemorrhage with rupture of bridging veins is exceptional in this context.
期刊介绍：
Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology
Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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