Magnetic resonance imaging of optic nerve and optic sheath hemorrhages in child abuse

Pediatr Radiol. 2021 May;51(6):997-1002. doi: 10.1007/s00247-020-04891-y. Epub 2021 May 17.

Abstract

In abusive head trauma victims, optic nerves and optic sheath hemorrhages are commonly associated with retinal hemorrhages. Until now, optic nerve and optic nerve sheath hemorrhages related to abusive head trauma have been identified by exenteration and soft-tissue sectioning during postmortem examination. In 2013, we proposed the use of tailored high-resolution susceptibility-weighted imaging (SWI) MRI sequences to depict retinal hemorrhages in lieu of the gold standard dilated fundus exam, in select patients, and in 2017 we showed how the same high-resolution sequences used in the coronal plane can depict ruptured bridging veins in abusive head trauma. This paper describes the new potential diagnostic application of high-resolution axial and coronal SWI in the diagnosis of optic nerve and optic sheath hemorrhages.

Keywords: Abusive head trauma; Child abuse; Children; Hemorrhage; Infants; Magnetic resonance imaging; Optic nerve; Retinal hemorrhage; Retinoschisis; Susceptibility-weighted imaging.

Publication types

  • Review

MeSH terms

  • Child
  • Child Abuse*
  • Craniocerebral Trauma*
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Optic Nerve / diagnostic imaging
  • Retinal Hemorrhage / diagnostic imaging