Spectrum of Magnetic Resonance Imaging Findings in Acute Pediatric Traumatic Brain Injury - A Pictorial Essay

Abstract

Cristina-Mihaela Popescu,1 Virginia Marina,2 Georgiana Avram,3 Carmen Laura Cristescu Budala3 1Dental-Medicine Department, Faculty of Medicine and Pharmacy, “dunărea de Jos” University, Galați, 800201, Romania; 2Medical Department of Occupational Health, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800201, Romania; 3“sf. Ioan” Clinical Emergency Children’s Hospital, Galați, 800487, RomaniaCorrespondence: Virginia Marina, Tel [phone], Email [email protected]: Head trauma (HT) in pediatric patients is the number one cause of mortality and morbidity in children. Although computer tomography (CT) imaging provides ample information in assessing acute traumatic brain injuries (TBIs), there are instances when magnetic resonance imaging (MRI) is needed. Due to its high sensitivity in diagnosing small bleeds, MRI offers a well-documented evaluation of primary acute TBIs. Our pictorial essay aims to present some of the latest imaging protocols employed in head trauma and review some practical considerations. Injury mechanisms in accidental HT, lesions’ topography, and hematoma signal variability over time are also discussed. Acute primary intra- and extra-axial lesions and their MRI aspect are showcased using images from patients in our hospital. This pictorial essay has an educational purpose. It is intended to guide young emergency and intensive care unit doctors, neurologists, and neurosurgeons in diagnosing acute primary TBIs on MRI while waiting for the official radiologist’s report. The presentation focuses on the most frequent traumatic lesions encountered in acute pediatric head trauma.Keywords: paediatric head trauma, traumatic brain injury, diffuse axonal injury, haemorrhagic cortical contusions, epidural haematoma

Keywords

• paediatric head trauma
• traumatic brain injury
• diffuse axonal injury
• haemorrhagic cortical contusions
• epidural haematoma