Intracranial hemorrhage in children younger than 3 years: prediction of intent.
OBJECTIVE
To determine whether certain computed tomographic imaging patterns in infants and young children with intracranial hemorrhage help predict intentional compared with unintentional injuries.


METHODS
Retrospective consecutive case series over a 10-year period.


METHODS
Two hundred ninety-three children younger than 3 years with intracranial hemorrhage.


METHODS
The sensitivity and specificity of computed tomographic imaging patterns for intentional head injury.


METHODS
Regional pediatric medical center.


RESULTS
Four variables used in the multiple logistic regression analysis for predicting intentional head injury were statistically significant (P<.05): subdural hematoma located over the cerebral convexities, hematoma within the interhemispheric subdural space, hygroma (nonhemic subdural fluid) with intracranial hemorrhage, and absence of a skull fracture with intracranial hemorrhage. The prediction model for the diagnosis of intentional head trauma using combinations of these 4 variables and a.45 probability cutoff point indicated a sensitivity of 84% (95% confidence interval, 78%-90%) and a specificity of 83% (95% confidence interval, 74%-89%).


CONCLUSIONS
Computed tomographic imaging patterns of intracranial hemorrhage in children younger than 3 years help predict whether the injury was intentional.
Wells
Robert G
RG
Radiology Department, MS 721, Children's Hospital of Wisconsin, 9000 W Wisconsin Ave, PO Box 1997, Milwaukee, WI 53201, USA. rwells@chw.org
Vetter
Christine
C
Laud
Prakash
P
D017677:Age Distribution; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014922:Wisconsin / Q000453:epidemiology