Spinal subdural hemorrhage in abusive head trauma: a pictorial review

Pediatr Radiol. 2021 May;51(6):980-990. doi: 10.1007/s00247-020-04931-7. Epub 2021 May 17.


A growing body of evidence links abusive head trauma (AHT) to patterns of direct and indirect spinal injuries, such as spinal subdural hemorrhage (SDH). Identification of evidence of spinal injury such as spinal SDH plays a crucial role in the diagnosis and subsequent management of the index child with AHT and his or her siblings. In a value-based practice of medicine, it can be argued that adding spine imaging to identify spinal SDH in the workup of AHT adds value to both the short- and long-term management of the patient. This pictorial review describes the normal appearance of spinal SDH and challenges of identifying spinal SDH, and it explores the mechanism of spinal SDH development in AHT.

Keywords: Abusive head trauma; Children; Infants; Injury; Magnetic resonance imaging; Spine; Subdural hemorrhage.

Publication types

  • Review

MeSH terms

  • Child
  • Child Abuse* / diagnosis
  • Craniocerebral Trauma* / diagnostic imaging
  • Female
  • Hematoma, Subdural / diagnostic imaging
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies