Abusive head trauma

Case contributed by Hidayatullah Hamidi


Apart from vomiting and seizure, no other specific history was provided by the patient's care takers nor the referral physician.

Patient Data

Age: 30 days
Gender: Male

Acute subdural hematoma along the left cerebral hemisphere extending along the falx with a maximum thickness of 9 mm.

Acute intraparenchymal hematoma in the left parietal lobe measuring 15x20x22 cm.

Diffuse hypo-attenuation of the left cerebral hemisphere with altered grey-white matter differentiation and effacement of cerebellar sulci, left lateral ventricle and midline shift of approximately 4mm towards the right side representing acute ischemic changes/edema.

Mild dilatation of right lateral ventricle.

No fracture of skull bones.

Case Discussion

The constellation of imaging findings in this case are most suggestive of abusive head trauma (non-accidental brain injury), particularly with no relevant history provided by the carers. The carers were questioned but denied any involvement.

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