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Subdural Hematomas in Infants with Benign Enlargement of the Subarachnoid Spaces Are Not Pathognomonic for Child Abuse

P.D. McNeelya, J.D. Atkinsonb, G. Saigalc, A.M. O’Gormanc and J.-P. Farmerb

a Division of Neurosurgery, Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
b Division of Neurosurgery, Department of Surgery, Montreal Children’s Hospital, McGill University, Montreal, Quebec, Canada
c Department of Radiology, Montreal Children’s Hospital, McGill University, Montreal, Quebec, Canada


Figure 1
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  		Fig 1. Axial fluid-attenuated inversion recovery MR image showing prominent CSF equivalent subarachnoid spaces in both frontal regions. No subdural hemorrhage is noted.


Figure 2
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  		Fig 2. Axial fluid-attenuated inversion recovery MR of same patient as in Fig 1 done 19 days later (patient remained hospitalized) now showing an isointense area in the left subdural space, consistent with a hematoma. The subarachnoid CSF space is seen clearly separate from the overlying subdural space containing the hematoma.


Figure 3
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  		Fig 3. Axial CT scan showing prominent subarachnoid spaces in both frontal regions.


Figure 4
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  		Fig 4. Axial fluid-attenuated inversion recovery MR sequence showing thin bilateral subdural hematomas that are seen separate from the underlying subarachnoid space.


Figure 5
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  		Fig 5. Axial T2-weighted MR image also showing the thin bilateral subdural hematomas.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X