1. BROOKLYN 3 STUDENTS Bridgette MAIR Fri 30 th Aug 2013 Session 3 / Talk 4 13:45 – 13:55 ABSTRACT Subdural haematomas are the most common form of traumatic injury and make up 80% of head injury from non-accidental injuries. Diagnosis of subdural haematomas can be difficult as the child regularly has non-specific symptoms and lacks external cues. Neuroimaging is a fundamental investigation in obtaining diagnosis of subdural haematomas. It is therefore essential to understand the role of MRI in demonstrating subdural haematomas for diagnosis to be achieved, enabling correct management steps to be ascertained improving the prognosis of paediatrics subjected to non-accidental injury. The aim of this literature review is to explain the role MRU plays in diagnosing subdural haematomas in NAI paediatrics. This was completed by reviewing 15 literature articles from 1999 to understand the role it plays and why. It was concluded that while CT remains the most appropriate initial modality of choice for suspected NAI cases die to accessibility, speed and ease, MRI is the test of choice to demonstrate SDH due to its higher level specificity and aging of multiple haematomas if present.

2. The role of magnetic resonance imaging in diagnosing subdural haematomas in non-accidental injury paediatrics

4. Nia Glassie Kahui Twins

5. Date of InjuryNameAgeCause of death May 2006Kahui Twins3 monthsSevere head injuries August 2007Nia Glassie3 yearsBrain injuries and other abuse January 2008Tahani Mahomed11 weeksSevere brain injuries August 2009Kash McKinnon3 yearsSevere head injuries September 2009Hail-Sage McClutchie22 monthsSerious head injuries July 2010Cezar Taylor6 monthsSerious head injuries April 2011Serenity Scott5 monthsSerious brain injury

9. PatientAge Clinical Presentation CT TimeMRI TimeDiagnosis A2 months Fever – 24 hours, seizures, anemia Day of admission 15 days post admission MRI showed multiple SDH’s of different ages. NAI confirmed B3½ months Anorexia and drowsiness Day of admission 5 days post admission CT showed chronic SDH. MRI confirmed an acute SDH also. NAI was confirmed C5½ months H/O head trauma, LOC, irritable Day of admission 20 days post admission CT showed SDH. MRI showed multiple SDH of different ages. NAI confirmed

10. PatientAge Clinical Presentation CT TimeMRI TimeDiagnosis D4½ months Left sided seizures Day of admission 20 days post admission CT and MRI both showed abnormalities with haemorrhage noted. MRI was suggestive of NAI but could not be confirmed E1½ months Respiratory distress, apnoea Day of admission 2 days post admission CT showed malformation due to injury. MRI showed multiple SDH’s of different ages in multiple brain lobes. NAI confirmed F2 monthsApnoea Day of admission 6 days post admission Skeletal survey was done on admission showing numerous fractures. CT was normal. MRI showed a chronic SDH. NAI confirmed

11. Image shows subdural haematomas performed by CT-image set A, and by MRI- image set 2

12. Any Questions?