Tadpole sign (bridging vein thrombosis)
Citation, DOI, disclosures and article data
Citation:
Hellwig D, Sharma R, Elfeky M, et al. Tadpole sign (bridging vein thrombosis). Reference article, Radiopaedia.org (Accessed on 20 Mar 2025) https://doi.org/10.53347/rID-74038
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rID:
74038
Article created:
3 Feb 2020,
Dane Hellwig
Disclosures:
At the time the article was created Dane Hellwig had no recorded disclosures.
View Dane Hellwig's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures
Revisions:
8 times, by
8 contributors -
see full revision history and disclosures
Systems:
Sections:
Synonyms:
- Lollipop sign
The tadpole sign, also known as the lollipop sign, refers to a characteristic morphology of post-traumatic bridging vein thrombosis with a rounded "head" and a tapering "tail". The question of whether this finding demonstrates a high specificity for abusive head trauma, a sub-type of non-accidental injury is a matter of discussion in the literature. Presence of this sign may warrant further investigation into possible non-accidental aetiology of injury.
Pathology
This sign may be suggestive of injury secondary to a shaking mechanism (as opposed to axial loading via "slamming"). The characteristic morphology is thought to occur because the combination of the high relative weight of the infant head and weak neck musculature allows for increased torque and thus predisposition to shearing and rupture of small bridging veins in the subdural space and subarachnoid space. This idea has been challenged by those who claim that this mechanism has not been confirmed biomechanically.
References
- 1. Divya Gunda, Benjamin O. Cornwell, Hisham M. Dahmoush, Sammer Jazbeh, Anthony M. Alleman. Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas. (2018) RadioGraphics. 39 (1): 213-228. doi:10.1148/rg.2019180084 - Pubmed
- 2. Hahnemann ML, Kinner S, Schweiger B, Bajanowski T, Karger B, Pfeiffer H, Wittschieber D. Imaging of bridging vein thrombosis in infants with abusive head trauma: the "Tadpole Sign". (2015) European radiology. 25 (2): 299-305. doi:10.1007/s00330-014-3443-z - Pubmed
- 3. Zahl S, Mack J, Rossant C, Squier W, Wester K. Thrombosis is Not a Marker of Bridging Vein Rupture in Infants with Alleged Abusive Head Trauma. Acta Paediatr. 2021;110(10):2686-94. doi:10.1111/apa.15908 - Pubmed
Incoming Links
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