In Vivo Demonstration of Traumatic Rupture of the Bridging Veins in Abusive Head Trauma
Abstract Objective In victims of abusive head trauma (AHT), bridging vein thrombosis (BVT) is a common finding depicted on MR imaging. We aimed to evaluate the utility of high-resolution coronal susceptibility weighted imaging (SWI) in depicting BVT, and to verify the appearance of BVT on axial SWI....
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Published in | Pediatric neurology Vol. 72; pp. 31 - 35 |
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Language | English |
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Abstract | Abstract Objective In victims of abusive head trauma (AHT), bridging vein thrombosis (BVT) is a common finding depicted on MR imaging. We aimed to evaluate the utility of high-resolution coronal susceptibility weighted imaging (SWI) in depicting BVT, and to verify the appearance of BVT on axial SWI. We additionally looked at the presence of correlations between BVT or bridging vein deformation and other MR imaging findings usually described in association with AHT. Methods 17 patients with a diagnosis of AHT were retrospectively evaluated for the presence of thrombosis on axial SWI. The affected veins were localized on coronal SWI, and the strength of association between the presence of BVT on axial versus high-resolution coronal SWI was determined. Results Of 11 patients identified with thrombosis on axial SWI, high-resolution coronal SWI verified BVT in 4 cases (36%). The previously reported “tadpole sign” on axial images did not predict BVT on coronal SWI [OR=0.3 (0.02, 5.01), p=0.538]. Volumetric coronal SWI disclosed additional irregularities of the bridging veins’ walls, which was associated with the presence of subdural hematoma on MR imaging (p=0.03), suggesting traumatic injury. Conclusion Coronal SWI confirmed thrombosis of the bridging veins being only in a minority of cases. Diffusely irregular contours of the veins observed on high-resolution coronal SWI was a major finding in our study. Disruption of the normal anatomy of the bridging veins in abusive head trauma further supports the traumatic nature of the disease. |
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AbstractList | Abstract Objective In victims of abusive head trauma (AHT), bridging vein thrombosis (BVT) is a common finding depicted on MR imaging. We aimed to evaluate the utility of high-resolution coronal susceptibility weighted imaging (SWI) in depicting BVT, and to verify the appearance of BVT on axial SWI. We additionally looked at the presence of correlations between BVT or bridging vein deformation and other MR imaging findings usually described in association with AHT. Methods 17 patients with a diagnosis of AHT were retrospectively evaluated for the presence of thrombosis on axial SWI. The affected veins were localized on coronal SWI, and the strength of association between the presence of BVT on axial versus high-resolution coronal SWI was determined. Results Of 11 patients identified with thrombosis on axial SWI, high-resolution coronal SWI verified BVT in 4 cases (36%). The previously reported “tadpole sign” on axial images did not predict BVT on coronal SWI [OR=0.3 (0.02, 5.01), p=0.538]. Volumetric coronal SWI disclosed additional irregularities of the bridging veins’ walls, which was associated with the presence of subdural hematoma on MR imaging (p=0.03), suggesting traumatic injury. Conclusion Coronal SWI confirmed thrombosis of the bridging veins being only in a minority of cases. Diffusely irregular contours of the veins observed on high-resolution coronal SWI was a major finding in our study. Disruption of the normal anatomy of the bridging veins in abusive head trauma further supports the traumatic nature of the disease. OBJECTIVEIn victims of abusive head trauma, bridging vein thrombosis is a common finding on magnetic resonance imaging. We aimed to evaluate the utility of high-resolution coronal susceptibility-weighted imaging (SWI) in depicting bridging vein thrombosis as well as to verify the morphology of the bridging vein thrombosis on axial SWI. We additionally analyzed the correlations between bridging vein thrombosis or bridging vein deformation and other magnetic resonance imaging findings that often occur in association with abusive head trauma.METHODSSeventeen patients with abusive head trauma were retrospectively evaluated for the presence of thrombosis on axial SWI. The affected veins were localized on coronal SWI, and the strength of association between the presence of bridging vein thrombosis on axial versus high-resolution coronal SWI was determined.RESULTSOf 11 patients identified with thrombosis on axial SWI, high-resolution coronal SWI verified bridging vein thrombosis in four individuals (36%). The previously reported "tadpole sign" on axial images did not predict bridging vein thrombosis on coronal SWI (odds ratio = 0.3 [0.02, 5.01], P = 0.538). Volumetric coronal SWI disclosed additional irregularities of the bridging vein walls which was associated with the presence of subdural hematoma on magnetic resonance imaging (P = 0.03), suggesting traumatic injury.CONCLUSIONCoronal SWI confirmed thrombosis of the bridging veins only in a minority of cases. Diffusely irregular contours of the veins observed on high-resolution coronal SWI was a major finding in our study. Disruption of the normal anatomy of the bridging veins in abusive head trauma further supports the traumatic nature of the disease. In victims of abusive head trauma, bridging vein thrombosis is a common finding on magnetic resonance imaging. We aimed to evaluate the utility of high-resolution coronal susceptibility-weighted imaging (SWI) in depicting bridging vein thrombosis as well as to verify the morphology of the bridging vein thrombosis on axial SWI. We additionally analyzed the correlations between bridging vein thrombosis or bridging vein deformation and other magnetic resonance imaging findings that often occur in association with abusive head trauma. Seventeen patients with abusive head trauma were retrospectively evaluated for the presence of thrombosis on axial SWI. The affected veins were localized on coronal SWI, and the strength of association between the presence of bridging vein thrombosis on axial versus high-resolution coronal SWI was determined. Of 11 patients identified with thrombosis on axial SWI, high-resolution coronal SWI verified bridging vein thrombosis in four individuals (36%). The previously reported “tadpole sign” on axial images did not predict bridging vein thrombosis on coronal SWI (odds ratio = 0.3 [0.02, 5.01], P = 0.538). Volumetric coronal SWI disclosed additional irregularities of the bridging vein walls which was associated with the presence of subdural hematoma on magnetic resonance imaging (P = 0.03), suggesting traumatic injury. Coronal SWI confirmed thrombosis of the bridging veins only in a minority of cases. Diffusely irregular contours of the veins observed on high-resolution coronal SWI was a major finding in our study. Disruption of the normal anatomy of the bridging veins in abusive head trauma further supports the traumatic nature of the disease. |
Author | Tamber, Mandeep S., MD, PhD Panigrahy, Ashok, MD Zuccoli, Giulio, MD Khan, Abdullah S |
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Keywords | Abusive head trauma bridging vein thrombosis susceptibility-weighted imaging pediatrics abusive head trauma |
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Snippet | Abstract Objective In victims of abusive head trauma (AHT), bridging vein thrombosis (BVT) is a common finding depicted on MR imaging. We aimed to evaluate the... In victims of abusive head trauma, bridging vein thrombosis is a common finding on magnetic resonance imaging. We aimed to evaluate the utility of... OBJECTIVEIn victims of abusive head trauma, bridging vein thrombosis is a common finding on magnetic resonance imaging. We aimed to evaluate the utility of... |
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SubjectTerms | abusive head trauma bridging vein thrombosis Cerebral Veins - diagnostic imaging Child Abuse Craniocerebral Trauma - complications Craniocerebral Trauma - diagnostic imaging Female Humans Infant Magnetic Resonance Imaging - methods Male Neurology Pediatrics Retrospective Studies susceptibility-weighted imaging Venous Thrombosis - diagnostic imaging Venous Thrombosis - etiology |
Title | In Vivo Demonstration of Traumatic Rupture of the Bridging Veins in Abusive Head Trauma |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S0887899417301200 https://dx.doi.org/10.1016/j.pediatrneurol.2017.04.003 https://www.ncbi.nlm.nih.gov/pubmed/28465135 https://search.proquest.com/docview/1894914956 |
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