Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury

Acute CT/MRI findings were examined in a prospective, longitudinal study of 60 children 0-6 years of age hospitalized for moderate to severe traumatic brain injury (TBI). TBI was categorized as either inflicted (n=31) or noni nflicted (n=29). Glasgow Coma Scale scores and perinatal history were compa rable in both groups. Acute CT/MRI studies were visually inspected by a rad iologist blind to group membership. Compared with the noninflicted TBI grou p, the inflicted TBI group had significantly elevated rates of subdural int erhemispheric and convexity hemorrhages as well as signs of pre-existing br ain abnormality, including cerebral atrophy, subdural hygroma, and ex vacuo ventriculomegaly. Intraparenchymal hemorrhage, shear injury, and skull fra ctures were more frequent after noninflicted TBI. Subarachnoid hemorrhage a nd infarct/edema occurred with comparable frequency in both groups. Charact eristic acute neuroimaging findings of inflicted TBI included multiple extr aaxial hemorrhages in addition to the mild atrophy, subdural hygromas, and ventriculomegaly that suggest prior brain abnormality.