TY  - JOUR
PY  - 2018//
TI  - Prevalence, patterns, and clinical relevance of hypoxic-ischemic injuries in children exposed to abusive head trauma
JO  - Journal of neuroimaging
A1  - Orru', Emanuele
A1  - Huisman, Thierry A. G. M.
A1  - Izbudak, Izlem
SP  - 608
EP  - 614
VL  - 28
IS  - 6
N2  - BACKGROUND AND PURPOSE: Hypoxic-ischemic injuries (HIIs) are a scarcely investigated but important cause of morbidity and mortality in children who suffered abusive head trauma (AHT). The purpose of this study is to determine: (a) prevalence, types, and clinical relevance of cytotoxic edema compatible with HII in nonpenetrating AHT, (b) their relationship to other classic neuroimaging findings of AHT, and (c) their correlation with clinical outcomes. <br><br>METHODS: Diffusion-weighted imaging sequences of magnetic resonance imagings performed on children under 5 years diagnosed with AHT were reviewed to detect the most common patterns of acute parenchymal damage. Patterns of cytotoxic edema were described, and HII-compatible ones divided in subtypes. Correlation between HII, fractures, and subdural hemorrhages (SDHs) and with clinical outcomes was determined using imaging and available follow-up data. <br><br>RESULTS: Out of 57 patients, 36.8% showed lesions compatible with HII. A predominantly asymmetric cortical distribution was observed in 66.7% of cases, while 33.3% had diffused both cortical and deep gray/white matter distribution injury. Traumatic axonal injuries and focal contusions were less common. There was no significant correlation between the presence of SDH (P =.6) or skull fractures (P =.53) and HII. HII was the most severe form of parenchymal damage in terms of in-hospital mortality and morbidity at follow-up. <br><br>CONCLUSIONS: HII is the most common type of parenchymal damage in children victim of AHT, being present in 1/3 of patients with this condition, and correlates with more severe outcomes. Its presence is independent from other classic traumatic findings such as SDH and fractures.<br><br>© 2018 by the American Society of Neuroimaging.<p />  <p>Language: en</p>
LA  - en
SN  - 1051-2284
UR  - http://dx.doi.org/10.1111/jon.12555
ID  - ref1
ER  -