Cerebral atrophy following shaken impact syndrome and other non-accidental head injury (NAHI).
OBJECTIVE
To determine the frequency of cerebral atrophy and microcephaly in a group of children with sequential MRI brain scans after surviving a non-accidental head injury (n = 16).


METHODS
Serial head circumference measurements (OFC) were extracted and plotted on standard growth charts for each child retrospectively to determine the frequency of secondary microcephaly. Cerebral atrophy was diagnosed and quantified by measurement of the ventricular/cortical ratio on coronal images of the sequential scans.


RESULTS
Acquired microcephaly was found in 15 children (93.8%) over a median follow-up period of 67.93 weeks. There was a significant reduction in the median Z-score for the OFC at the most recent follow-up when compared with that at presentation (p < 0.001, Wilcoxon Signed Rank Test). Cerebral atrophy was found to be the cause of the microcephaly in eight of the 15 children and was evident as early as 9 days after presentation.


CONCLUSIONS
A large proportion of the cohort (93.8%) develops acquired microcephaly after an inflicted head injury and cerebral atrophy is responsible in half of these cases.
Clinical Research Fellow, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, Scotland, UK.
T Y M
TY
Lo
M
M
McPhillips
R A
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Minns
R J
RJ
Gibson
D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002649:Child Abuse; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008831:Microcephaly / Q000453:epidemiology / Q000473:pathology; D038642:Shaken Baby Syndrome / Q000473:pathology*