Isolated cerebral cortical tears in children: aetiology, characterisation and differentiation from non-accidental head injury.
A wide spectrum of intracranial injuries has been described as complicating difficult birth, particularly following instrumental delivery. We describe five children in whom isolated cortical tears were observed on MRI. Four cases were characterised by a difficult instrumental delivery. None of the children developed long-term neurological sequelae. As far as we are aware, isolated cerebral cortical tears have not been reported previously although recognition of this injury pattern is important because of its possible misinterpretation as a marker of a non-accidental head injury. Other differential diagnoses that should be considered include cerebral infarcts, schizencephaly and accidental head injury. The importance of high-quality cross-sectional brain imaging in newborn infants with seizures is emphasised.
Au-Yong
I T H
IT
Queens Medical Centre, Derby Road, Nottingham, Nottinghamshire NG7 2UH, UK.
Wardle
S P
SP
McConachie
N S
NS
Jaspan
T
T
D001720:Birth Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D020520:Brain Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging; D001930:Brain Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000293:injuries*; D002649:Child Abuse / Q000175:diagnosis; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000175:diagnosis / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography