Table 3.
Spinal cord AHT pathological findings: evidence from neuroradiology (case series and case reports). Is intracranial SDH associated?
| Study | Cases | Spinal cord injuries | Intracranial SDH in AHT cases | Is intracranial SDH inclusion criteria? |
|---|---|---|---|---|
| Rabbitt et al., 2020 [41] | 47 AHT and 29 accidental head trauma (mean age and age interval are not given) | Spinal SDH was the only finding associated with a combination of RH (p = 0.001), non-contact head injury (p = 0.008) and AHT diagnosis (p < 0.05). | Yes (fifty-nine children (78%) who received an MRI spine had an intracranial haemorrhage on MRI brain. Of these, 11 (19%) had co-occurring spinal SDH). | No |
| Hong et al., 2019 [53] | Case report of a 5-month-old boy | Spinal SDH from T4 to L5 | Yes | Yes |
| Henry et al., 2018 [43] | 74 AHT and 14 accidental head trauma (<2 y) | 23% of AHT and 1.3% of accidental head trauma had extra-axial haemorrhage | Yes (87%) | No |
| Oh et al., 2017 [44] | 91 abuse trauma (<9 y, ma 6 mo) | 2/91 had SDH, 4 had spinal cord injuries | Not reported | Yes, but not exclusively |
| Agarwal et al., 2016 [52] | Case report of a 6-month-old girl | Spinal SDH from thoracolumbar junction to the sacrum with mild mass effect | Yes | Yes |
| Jacob et al., 2016 [46] | 89 AHT (<5 y, ma 9.1 mo) | Overall spinal cord injuries: 69% (67% ligamentous, 18% SDH) | Yes | No |
| Kandom et al., 2014 [16] | 38 AHT and 26 accidental head trauma and 10 undefined-head trauma (0.6 mo–22.6 mo, ma 5.5 mo) |
1 child had intrathecal haemorrhage 2 children had spinal cord injuries |
Yes | Yes |
| Choundhary et al., 2014 [47] | 67 AHT and 46 accidental head trauma and 70 non-traumatic (all <48 months, ma 4 mo, 15 mo, 14 mo, respectively) |
48% of AHT vs 2% of accidental head trauma had SDH (all in association with intracranial SDH). None of the non-traumatic had SDH. |
Yes | No |
| Choundhary et al., 2012 [48] | 67 AHT and 70 accidental head trauma (between 0 and 2 y) who underwent CT/MRI of head and spinal cord |
46% of AHT had SDH as compared with 1% of accidental head trauma. SDH finding is more frequent at thoracolumbar than cervical levels (63% vs 24%) (all in association with intracranial SDH). Accidental head trauma |
Yes | No |
| Edelbauer et al., 2012 [49] | 6 AHT and 12 non-traumatic (ma 3.3 and 2.5 months, respectively) | Spinal SDH was seen in all AHT children from the cervical to the cauda equina | Yes | No |
| Gruber et al., 2008 [51] | Case report of a 4-month-old boy | T10-L1 subdural haematoma | Yes | No |
| Koumellis et al., 2009 [50] | 18 AHT (ma 3 mo, 1–12 mo) | 8/18 (44%) had spinal SDH (all had the same intensity of posterior fossa SDH, and in 2 cases spinal collections were in continuity with intracranial collection) | Yes | No |
| Ghatan et al., 2002 [54] | 24-day-old girl | MRI showed ligamentous injury at occipitocervical junction, with atlantoaxial subluxation and narrowing of the spinal canal | Yes | No |
| Feldman et al., 1997 [40] |
12 AHT (mean age and age interval are not given) 5/12 deceased (1.3–34.1 mo, ma 5.8 mo) |
MRI showed no cervical spinal cord injuries (0/12) 4/5 had cervical spine bleeding at PM |
Yes | Yes |
| Diamond et al., 1994 [39] | 12-month-old girl | The MRI scan showed a T12-L3 pre-spinal mass possibly of haemorrhagic nature and tethered cord. | No | No |
AHT abusive head trauma, yo years old, ma mean age, mo months, MRI magnetic resonance, PM post mortem, SDH subdural haematoma