Aspects of neuroimaging in abusive head trauma
06 Feb 2019
This talk covers the increased use of cross-sectional imaging techniques over the past 20-30 years, which have made CT and MRI invaluable tools for the investigation of infants and children presenting to hospital, who have (or are suspected to have) sustained episodes of abusive head trauma (AHT). AHT causes characteristic (although not diagnostic) imaging appearances in terms of patterns of intracranial bleeding and of parenchymal brain injury.
What are the imaging features that should alert the radiologist to the possibility of AHT?
What are the optimal imaging protocols that should be followed when AHT is suspected?
On the basis of an up to date assessment of the relevant published literature and the personal experience of a neuroradiologist who has been instructed as an expert witness in just under 800 cases of alleged AHT, this presentation will:
• Attempt to provide answers to the above questions
• Explain the rationale for the imaging guidelines currently in use in the UK and highlight the importance of a systematic approach to the imaging investigations of these infants
• Illustrate the patterns of intracranial bleeding and brain injury seen in different types of paediatric head trauma
• Highlight the findings of the RCPCH Systematic Review Group relevant to cranio-spinal imaging in AHT
Educational aims:
• To understand the rationale for current imaging guidelines
• To understand the common distinguishing features of accidental and abusive trauma
• To understand the importance of the multidisciplinary team in management of such cases
References:
• Kemp AM et al. What neuroimaging should be performed in children in whom inflicted brain injury (iBI) is suspected? Clin Radiol 2009 May (64)5: 473-83.
• Kemp AM et al. Neuroimaging: What neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review. Arch Dis Child 2011 Dec; 96 (12) 1103-12.
• Maguire S et al. What clinical features distinguish inflicted from non-inflicted brain injury? A systematic review Arch Dis Child 2009 Nov; 94(11): 860-7.
1 CPD credit.
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate. You must login to watch the video and receive CPD.
What are the imaging features that should alert the radiologist to the possibility of AHT?
What are the optimal imaging protocols that should be followed when AHT is suspected?
On the basis of an up to date assessment of the relevant published literature and the personal experience of a neuroradiologist who has been instructed as an expert witness in just under 800 cases of alleged AHT, this presentation will:
• Attempt to provide answers to the above questions
• Explain the rationale for the imaging guidelines currently in use in the UK and highlight the importance of a systematic approach to the imaging investigations of these infants
• Illustrate the patterns of intracranial bleeding and brain injury seen in different types of paediatric head trauma
• Highlight the findings of the RCPCH Systematic Review Group relevant to cranio-spinal imaging in AHT
Educational aims:
• To understand the rationale for current imaging guidelines
• To understand the common distinguishing features of accidental and abusive trauma
• To understand the importance of the multidisciplinary team in management of such cases
References:
• Kemp AM et al. What neuroimaging should be performed in children in whom inflicted brain injury (iBI) is suspected? Clin Radiol 2009 May (64)5: 473-83.
• Kemp AM et al. Neuroimaging: What neuroradiological features distinguish abusive from non-abusive head trauma? A systematic review. Arch Dis Child 2011 Dec; 96 (12) 1103-12.
• Maguire S et al. What clinical features distinguish inflicted from non-inflicted brain injury? A systematic review Arch Dis Child 2009 Nov; 94(11): 860-7.
1 CPD credit.
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate. You must login to watch the video and receive CPD.
Duration:33 mins
Speaker info
Neil Stoodley
Consultant Neuroradiologist, Bristol Royal Hospital for Children NHS Foundation Trust. Dr Neil Stoodley qualified from Oxford in 1985 and after initial training in general and paediatric surgery, saw the light and transferred to radiology training in Southampton and Oxford. He was initially appointed as a Consultant to the University Hospital of Wales in 1998 and transferred to Bristol in 2002. He has been instructed as an independent expert in over 950 cases of alleged abusive head trauma and has given oral evidence to various types of court on over 450 occasions. He sits on a number of guideline development groups related to the topic and is a member of the RCPCH Systematic Review Group.