Mortality after abusive head trauma: Relationship to brain injury severity, age, and co-occurring bodily injuries.

Background: Abusive head trauma (AHT), a leading cause of death from child physical abuse, disproportionately impacts the youngest children. Identifying children at highest risk following AHT has been hampered by the lack of a widely accepted measure of brain injury severity in infants and toddlers.

Objective: Identify clinical factors associated with mortality from AHT.

Changing Management of Focal Cerebral Arteriopathy of Childhood From 2010 to 2022.

Background: The most common cause of arterial ischemic stroke in healthy children, focal cerebral arteriopathy (FCA), can progress rapidly over days with worsening brain injury. A 2017 retrospective Swiss study of corticosteroid treatment for FCA changed practice. To assess its impact, we compared the FCA cohorts from the 2 VIPS (Vascular Effects of Infection in Pediatric Stroke) prospective cohort studies.

Injury, child and family factors predict neurodevelopment outcomes after abusive head trauma.

Background: There is a lack of consensus on how best to measure injury severity in abusive head trauma in order to predict long-term neurodevelopmental outcomes.

Objective: We hypothesized that a constellation of injury-related variables along with child and family variables would more accurately predict outcomes in children who have sustained an AHT than the Glasgow Coma Scale (GCS) alone.

Participants And Setting: In 2012-2020, we enrolled 270 patients (median age 4.

Cytotoxic edema is associated with injury severity but not abusive mechanism in young children with traumatic brain injury.

Background: Cytotoxic Edema (CE) is a form of brain parenchymal injury hypothesized to be associated with abusive mechanism and poor outcome for young children with traumatic brain injury. CE is reliably identified by magnetic resonance imaging but not by computed tomography.

Objective: We sought to test the association of CE with injury severity, mechanism (abusive or non-abusive) and functional outcome in a large cohort of young children who all had magnetic resonance imaging.

Steno-occlusive Intracranial Large Vessel Arteriopathies in Childhood: A Pattern Oriented Approach to Neuroimaging Diagnosis.

Intracranial steno-occlusive large vessel arteriopathies refer to abnormalities of the arterial wall that typically express luminal stenosis. Notably, some entities that can find themselves within this category may also express luminal dilation, and/or aneurysm formation as an alternative phenotype. Intracranial steno-occlusive large vessel arteriopathies are a leading cause of arterial ischemic stroke (AIS) in children, often progress, and can predispose to recurrent brain infarction.

Child life specialists predict successful MRI scanning in unsedated children 4 to 12 years old.

Background: It can be challenging for children to cooperate for a magnetic resonance imaging (MRI) exam. General anesthesia is often used to ensure a high-quality image. When determining the need for general anesthesia, many institutions use a simple age cutoff.

Urine biomarkers of acute kidney injury and association with brain MRI abnormalities in neonatal hypoxic-ischemic encephalopathy.

Objective: Determine whether urine biomarkers NGAL (neutrophil gelatinase-associated lipocalin), KIM-1 (kidney injury molecule 1) and IL-18 (interleukin-18) are associated with abnormal MRI findings in neonates with hypoxic-ischemic encephalopathy (HIE) who underwent therapeutic hypothermia (TH).

Study Design: Secondary analysis of a multicenter, prospective study of neonates with HIE requiring TH. Urine biomarkers were obtained at 12 and 24 h of life (HOL).

Utility of Early Magnetic Resonance Imaging to Enhance Outcome Prediction in Critically Ill Children with Severe Traumatic Brain Injury.

Background: Many children with severe traumatic brain injury (TBI) receive magnetic resonance imaging (MRI) during hospitalization. There are insufficient data on how different patterns of injury on early MRI inform outcomes.

Methods: Children (3-17 years) admitted in 2010-2021 for severe TBI (Glasgow Coma Scale [GCS] score < 9) were identified using our site's trauma registry.

The Inner Complexities of Multimodal Medical Data: Bitmap-Based 3D Printing for Surgical Planning Using Dynamic Physiology.

Motivated by the need to develop more informative and data-rich patient-specific presurgical planning models, we present a high-resolution method that enables the tangible replication of multimodal medical data. By leveraging voxel-level control of multimaterial three-dimensional (3D) printing, our method allows for the digital integration of disparate medical data types, such as functional magnetic resonance imaging, tractography, and four-dimensional flow, overlaid upon traditional magnetic resonance imaging and computed tomography data. While permitting the explicit translation of multimodal medical data into physical objects, this approach also bypasses the need to process data into mesh-based boundary representations, alleviating the potential loss and remodeling of information.

Variants in PTEN Are Associated With a Diverse Spectrum of Cortical Dysplasia.

Background: Inactivating mutations in PTEN are among the most common causes of megalencephaly. Activating mutations in other nodes of the PI3K/AKT/MTOR signaling pathway are recognized as a frequent cause of cortical brain malformations. Only recently has PTEN been associated with cortical malformations, and analyses of their prognostic significance have been limited.

The development of the pediatric stroke neuroimaging platform (PEDSNIP).

Childhood stroke occurs from birth to 18 years of age, ranks among the top ten childhood causes of death, and leaves lifelong neurological impairments. Arterial ischemic stroke in infancy and childhood occurs due to arterial occlusion in the brain, resulting in a focal lesion. Our understanding of mechanisms of injury and repair associated with focal injury in the developing brain remains rudimentary.

Dots and spots: A retrospective review of T2-hyperintense white matter lesions in pediatric patients with and without headache.

Objective: We aimed to determine if T2-weighted hyperintense white matter lesions (WMLs) on brain magnetic resonance imaging (MRI) occur more frequently in pediatric patients with migraine and other primary headache disorders compared to the general pediatric population.

Background: Small foci of T2 hyperintensity in the white matter are frequently identified on brain MRI during the workup of pediatric headache. Such lesions have been reported to be more common among adults with migraine versus adults without migraine; however, this association has not been well established in the pediatric population.

Fusion of Lateral Calvarial Sutures on Volume-Rendered Computed Tomography Reconstructions in Patients With Known Craniosynostosis.

Introduction: After treating a child with familial sagittal craniosynostosis, clinocephaly, and bilateral parietomastoid/posterior squamosal suture fusion, the authors wondered if major-suture synostosis and clinocephaly were associated with abnormal fusion of minor lateral calvarial sutures.

Methods: The authors reviewed all preoperative volume-rendered head computed tomography reconstructions performed for craniosynostosis at their institution from 2010 through 2014 and determined whether the sphenoparietal, squamosal, and parietomastoid sutures were open, partially fused, or fused. The authors determined whether any sutures were abnormally fused based upon a previous study from their center, in which abnormal fusion was defined as either 1 of 3 abnormal fusion patterns or abnormally-early fusion.

Defining Soft Tissue: Bitmap Printing of Soft Tissue for Surgical Planning.

Nearly all applications of 3D printing for surgical planning have been limited to bony structures and simple morphological descriptions of complex organs due to the fundamental limitations in accuracy, quality, and efficiency of the current modeling paradigms and technologies. Current approaches have largely ignored the constitution of soft tissue critical to most surgical specialties where multiple high-resolution variations transition gradually across the interior of the volume. Differences in the scales of organization related to unique organs require special attention to capture fine features critical to surgical procedures.

Megacystis Associated With an Underlying ACTA2 Variant and Diagnosis of Multisystemic Smooth Muscle Dysfunction Syndrome: A Case Report.

Fetal megacystis, or an enlarged fetal bladder, is most often attributed to embryological defects, occurring early in gestation. Recent investigations have demonstrated that the underlying etiology of megacystis may be more myriad than originally thought. We present the third reported patient with megacystis due to an ACTA2 Arg179 substitution variant causing Multisystemic Smooth Muscle Dysfunction Syndrome.

Ketogenic diet as a glycine lowering therapy in nonketotic hyperglycinemia and impact on brain glycine levels.

Background: Nonketotic hyperglycinemia (NKH) is a severe neurometabolic disorder characterized by increased glycine levels. Current glycine reduction therapy uses high doses of sodium benzoate. The ketogenic diet (KD) may represent an alternative method of glycine reduction.

Neuroimaging in Pediatric Stroke.

Pediatric stroke is unfortunately not a rare condition. It is associated with severe disability and mortality because of the complexity of potential clinical manifestations, and the resulting delay in seeking care and in diagnosis. Neuroimaging plays an important role in the multidisciplinary response for pediatric stroke patients.

Imaging of Macrocephaly.

Macrocephaly is a common diagnosis in the pediatric population, particularly in the infantile time period. There is a wide range of causes of macrocephaly, from benign to malignant, for which imaging plays a key role in the diagnosis and clinical guidance. Our aim is to review the distinct and prevalent neuroimaging findings in the evaluation of the macrocephalic infant.

Perinatal Ischemic Stroke: Etiology and Imaging.

Perinatal ischemic stroke is a common cause of lifelong disability.

Fetal MRI Neuroradiology: Indications.

Fetal MRI is a safe, noninvasive examination of the fetus and placenta, a complement to ultrasonography. MRI provides detailed CNS evaluation, including depicting parenchymal architecture and posterior fossa morphology, and is key in prenatal assessment of spinal dysraphism, neck masses, and ventriculomegaly. Fetal MRI is typically performed after 22 weeks gestation, and ultrafast T1 and T2-weighted MRI sequences are the core of the exam, with advanced sequences such as diffusion weighted imaging used for specific questions.

Prevalence of cerebral sinovenous thrombosis in abusive head trauma.

Background: Cerebral sinovenous thrombosis (CSVT) has been proposed in legal settings to be an atraumatic mimic of abusive head trauma (AHT).

Objective: The objective of this study was to determine the prevalence of CSVT and subdural hemorrhage (SDH) in a large AHT population.

Materials And Methods: This retrospective cohort study measured the prevalence of CSVT and SDH on magnetic resonance venograms in 243 patients diagnosed with AHT at a single center.