Researchers at Penn State College of Medicine and Penn State Milton S. Hershey Medical Center (Hershey, Pennsylvania) have categorized the appearance and evolution of abnormalities on neuroimages that represent abusive head trauma (AHT) in infants. The researchers' descriptions of these abnormalities are important for narrowing down the timing of AHT, which can aid police in identifying and excluding potential perpetrators. Appearances of a variety of abusive traumatic injuries on cranial CT scans and MRIs at different time points are described and discussed in "Serial neuroimaging in infants with abusive head trauma: timing abusive injuries. Clinical article," by Ray Bradford, M.D., Arabinda K. Choudhary, M.D., M.R.C.P., F.R.C.R, and Mark S. Dias, M.D., published today online, ahead of print, in the Journal of Neurosurgery: Pediatrics. This study is the largest one on timing of AHT to date, and its findings confirm and extend those of a previous, smaller study conducted by the senior author, Dr. Mark S. Dias. The researchers hope that this article will serve as an important reference for professionals called upon to provide a time frame for abusive head injuries.
Dr. Bradford and colleagues examined the medical records and imaging studies of all infants (younger than 24 months of age) with abusive head trauma (AHT) who were admitted to Penn State Milton S. Hershey Medical Center between January 1997 and December 2007. The researchers identified 105 infants whose patient charts contained specific injury dates and for whom serial CT (computed tomography) scans were available. These infants were selected for the study population; they ranged in age from 0.3 to 23 months (mean age 5.3 months, median age 3.9 months). More precise timing of injury (time of day) was noted in the charts of 43 of these infants, and MRIs (magnetic resonance images) were available in all cases in this subgroup. In none of these cases was serial MRI scanning performed.