RT Journal Article
SR Electronic
T1 Limitations of T2*–Gradient Recalled-Echo and Susceptibility-Weighted Imaging in Characterizing Chronic Subdural Hemorrhage in Infant Survivors of Abusive Head Trauma
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1752
OP 1756
DO 10.3174/ajnr.A4769
VO 37
IS 9
A1 Cramer, J.A.
A1 Rassner, U.A.
A1 Hedlund, G.L.
YR 2016
UL http://www.ajnr.org/content/37/9/1752.abstract
AB SUMMARY: A possible misconception among radiologists is that chronic subdural hemorrhage should show some degree of blooming on T2*–gradient recalled-echo or susceptibility-weighted sequences such as SWI and susceptibility-weighted angiography, which is not necessarily true. We present 5 cases of chronic subdural hemorrhages in infants, demonstrating intensity near or greater than that of CSF with variable amounts of hemosiderin staining along the neomembranes. We review the physiology and MR imaging physics behind the appearance of a chronic subdural hemorrhage, highlighting that the absence of a BBB can allow hemosiderin to be completely removed from the subdural compartment. Finally, we stress the importance of reviewing all multiplanar sequences for the presence of neomembranes, which can be quite subtle in the absence of hemosiderin staining and are critical for making the diagnosis of chronic subdural hemorrhage.GREgradient recalled-echocSDHchronic subdural hemorrhageSDHsubdural hemorrhageSDHysubdural hygromaSWANsusceptibility-weighted angiography