title: Neuroradiological aspects of subdural haemorrhages.
abstract: OBJECTIVE
  To review the neuroimaging of a series of infants and young children admitted to hospital with subdural haemorrhage (SDH).
  
  
  METHODS
  Neuroradiological investigations of 74 children under 2 years of age, from South Wales and southwest England, in whom an SDH or subdural effusion had been diagnosed between 1992 and 2001, were reviewed. Two paediatric neuroradiologists blinded to the original radiological report reviewed all the relevant images.
  
  
  RESULTS
  Neuroradiological review of images identified radiological features which were highly suggestive of non-accidental head injury (NAHI). Interhemispheric haemorrhages and SDHs in multiple sites or of different densities were almost exclusively seen in NAHI. MRI was more sensitive in identifying SDHs of different signal characteristics, posterior and middle cranial fossa bleeds, and parenchymal changes in the brain. CT scans, if performed with suboptimal protocols, were likely to miss small subdural bleeds.
  
  
  CONCLUSIONS
  Guidelines for neuroimaging in suspected NAHI are recommended. A radiologist with experience in NAHI should report or review these scans. The initial investigation should be CT, but MRI will also be necessary in most cases. Head CT should be an integral part of the skeletal survey in all infants less than 6 months of age referred for child protection investigation, and in children less than 2 years where child abuse is suspected and there are neurological signs, retinal haemorrhages, or fractures.
authors.affiliation: Dept of Neuroradiology and Child Health, University Hospital of Wales, Cardiff, . shalinidatta@btinternet.com
authors.forename: S
authors.initials: S
authors.lastname: Datta
authors.forename: N
authors.initials: N
authors.lastname: Stoodley
authors.forename: S
authors.initials: S
authors.lastname: Jayawant
authors.forename: S
authors.initials: S
authors.lastname: Renowden
authors.forename: A
authors.initials: A
authors.lastname: Kemp
mesh_terms: D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis*; D002649:Child Abuse / Q000175:diagnosis*; D006408:Hematoma, Subdural / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D016037:Single-Blind Method; D013353:Subdural Effusion / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed