Abusive head trauma: Differentiation between impact and non-impact cases based on neuroimaging findings and skeletal surveys

T. Sieswerda-Hoogendoorn*, S. G. F. Robben, W. A. Karst, F. M. Moesker, M. van Aalderen, J. S. Lameris, R. R. van Rijn

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Web of Science)


Objectives: To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims. Methods: We included all AHT cases in the Netherlands in the period 2005-2012 for which a forensic report was written for a court of law, and for which imaging was available for reassessment. Neuroradiological and musculoskeletal findings were scored by an experienced paediatric radiologist. Results: We identified 124 AHT cases; data for 104 cases (84%) were available for radiological reassessment. The AHT victims with a skull fracture had fewer hypoxic ischaemic injuries than AHT victims without a skull fracture (p = 0.03), but the relative difference was small (33% vs. 57%). There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between impact and non-impact head trauma was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures. Conclusions: Neuroradiological and skeletal findings cannot discriminate between impact and non-impact head trauma in abusive head trauma victims.
Original languageEnglish
Pages (from-to)584-588
JournalEuropean Journal of Radiology
Issue number3
Publication statusPublished - Mar 2014


  • Abusive head trauma
  • Child abuse
  • Head injury, closed
  • Haematoma, subdural
  • Forensic medicine

Cite this