PITFALLS, MIMICS and CONTROVERSIES
•No other condition fully replicates the imaging findings of nonaccidental abuse. Entities which may deceive us include:
–Variations in suture anatomy, myelination patterns.
–Different appearances of normal anatomy (particularly infants)
–Coagulapathies (such as von Willenbrand’s and hemophilia).
–Metabolic disorders (especially Glutaric Aciduria Type I and Hemophagocytic Lymphohistocytosis)
–Accidental and Birth Trauma and
–Other Disease States (i.e. meningitis or malignancy)
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•There is debate over the importance of SDHs and retinal hemorrhage in abuse. Especially controversial is the association of benign external hydrocephalus and global hypoxia as a cause of SDH and retinal hemorrhages w/o trauma.
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