Citation, DOI, disclosures and article data
Citation:
Veiga M, Knipe H, Bell D, et al. Big black brain. Reference article, Radiopaedia.org (Accessed on 17 Feb 2025) https://doi.org/10.53347/rID-73458
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Micro-X Ltd, Shareholder (past)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Big black brain is a radiologic pattern unique to infants and toddlers in the context of traumatic brain injury, most frequently due to abusive head trauma.
Radiographic features
The CT presentation is parenchymal hypodensity and uniform loss of grey-white matter differentiation of the entire hemisphere associated with ipsilateral subdural hematoma.
The pattern can appear in the vascular territories of the anterior, middle, and posterior cerebral arteries without evidence of occluded blood vessels.
Although "black" may refer to hypodensity on CT, the pathology is apparent on MRI sequences, which will also show signal changes.
Treatment and prognosis
Frequently, there is subsequent hemispheric atrophy, resulting in severe motor impairment, cognitive impairment, epilepsy, and blindness.
-
1. Costine-Bartell B, McGuone D, Price G et al. Development of a Model of Hemispheric Hypodensity ("Big Black Brain"). J Neurotrauma. 2019;36(5):815-33. doi:10.1089/neu.2018.5736 - Pubmed
-
2. Duhaime A & Durham S. Traumatic Brain Injury in Infants: The Phenomenon of Subdural Hemorrhage with Hemispheric Hypodensity ("Big Black Brain"). Prog Brain Res. 2007;161:293-302. doi:10.1016/S0079-6123(06)61020-0 - Pubmed
Promoted articles (advertising)