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Chapter 6 - Shaken Baby Syndrome or Benign External Hydrocephalus

How Is Abusive Head Trauma Depicted in the Scientific Literature?

from Section 2 - Medicine

Published online by Cambridge University Press:  07 June 2023

By
Knut Wester ,
Johan Wikström  and
Joseph Scheller
Edited by
Keith A. Findley ,
Cyrille Rossant ,
Kana Sasakura ,
Leila Schneps ,
Waney Squier  and
Knut Wester
Keith A. Findley
Affiliation:
University of Wisconsin, Madison
Cyrille Rossant
Affiliation:
University College London
Kana Sasakura
Affiliation:
Konan University, Japan
Leila Schneps
Affiliation:
Sorbonne Université, Paris
Waney Squier
Affiliation:
John Radcliffe Hospital, Oxford
Knut Wester
Affiliation:
Universitetet i Bergen, Norway
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Summary

The radiological characteristics of abusive head trauma (AHT) appear to be vaguely defined. A literature search during the period 2008-21 identified 63 articles presenting 172 illustrations with subdural hematomas described as representative of AHT. We evaluated these for signs of benign external hydrocephalus (BEH) or expansive acute subdural haematoma (ASDH). Signs of BEH were widened interhemispheric distance, preserved subarachnoid space and preserved cortical relief despite an overlying SDH, and absence of ventricle compression or midline shift. Signs of an ASDH were hyperattenuating SDH combined with compression of the subarachnoid space, the cortical relief, and ventricles, as well as midline shift. Radiological findings suggesting BEH were detected in 59 illustrations (34.3%). A weaker suspicion of BEH was raised in 32 images. An expansive ASDH was detected in 24 images, and 57 illustrations showed neither signs of BEH nor expansive ASDH or were inconclusive. Males were overrepresented in all groups. Mean age was 4.2 months in the BEH-like group and 17.6 months in the ASDH-like group. BEH complicated by SDH may have been misdiagnosed as SBS/AHT in many of these articles.

Keywords

benign external hydrocephalusbenign enlargement of the subarachnoid spaceshydrocephalussubdural haematomacerebrospinal fluidchronic subdural haematomas
Type
Chapter
Information
Shaken Baby Syndrome
Investigating the Abusive Head Trauma Controversy
 , pp. 105 - 128
Publisher: Cambridge University Press
Print publication year: 2023

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