Venous injury in pediatric abusive head trauma: a pictorial review

Pediatr Radiol. 2021 May;51(6):918-926. doi: 10.1007/s00247-021-05016-9. Epub 2021 Apr 21.


Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. An intracranial pathology can exist even in the setting of a normal physical exam. A delay in the diagnosis of AHT can have serious life-threatening consequences for the child and increases the potential the child will be abused again. In this article, we review the traumatic subdural hematoma as well as various morpho-structural patterns of shearing injuries and thrombosis of intracranial bridging veins. This work serves as a summary of patterns of imaging features of intracranial venous injury in AHT, as described in the literature, to facilitate familiarity and early detection of abusive head trauma in the pediatric population. Essentially, in AHT there is a traumatic injury to the bridging vein with either partial or complete tear. This can secondarily result in thrombosis at the terminal end of the bridging vein with blood clots adjacent to the bridging vein.

Keywords: Abusive head trauma; Bridging vein; Child abuse; Computed tomography; Infants; Magnetic resonance imaging; Subdural hematoma.

Publication types

  • Review

MeSH terms

  • Child
  • Child Abuse* / diagnosis
  • Craniocerebral Trauma* / diagnostic imaging
  • Hematoma, Subdural / diagnostic imaging
  • Humans
  • Infant
  • Retrospective Studies
  • Vascular System Injuries*