Tessa Sieswerda-Hoogendoorn1, Floor A M Postema2, Dagmar Verbaan3, Charles B Majoie4, Rick R van Rijn5. 1. Section of Forensic Pediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague, The Netherlands; Department of Radiology, Academic Medical Center/Emma Children's Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: t.sieswerda@amc.nl. 2. Faculty of Medicine, University of Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: f.a.postema@amc.nl. 3. Department of Neurosurgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: d.verbaan@amc.nl. 4. Department of Radiology, Academic Medical Center/Emma Children's Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: c.b.majoie@amc.nl. 5. Section of Forensic Pediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague, The Netherlands; Department of Radiology, Academic Medical Center/Emma Children's Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: r.r.vanrijn@amc.nl.
Abstract
OBJECTIVES: To systematically review the literature on dating subdural hematomas (SDHs) on CT and MRI scans. METHODS: We performed a systematic review in MEDLINE, EMBASE and Cochrane to search for articles that described the appearance of SDHs on CT or MRI in relation to time between trauma and scanning. Two researchers independently screened the articles, assessed methodological quality and performed data extraction. Medians with interquartile ranges were calculated. Differences were tested with a Mann-Whitney U or Kruskal-Wallis H test. RESULTS: We included 22 studies describing 973 SDHs on CT and 4 studies describing 83 SDHs on MRI. Data from 17 studies (413 SDHs) could be pooled. There were significant differences between time intervals for the different densities on CT (p<0.001). Time interval differed significantly between children and adults for iso- and hypodensity (p=0.000) and hyperdensity (p=0.046). Time interval did not differ significantly between abused and non-abused children. On MRI, time intervals for different signal intensities on T1 and T2 did not differ significantly (p=0.108 and p=0.194, respectively). CONCLUSIONS: Most time intervals of the different appearances of SDHs on CT and MRI are broad and overlapping. Therefore CT or MRI findings cannot be used to accurately date SDHs.
OBJECTIVES: To systematically review the literature on dating subdural hematomas (SDHs) on CT and MRI scans. METHODS: We performed a systematic review in MEDLINE, EMBASE and Cochrane to search for articles that described the appearance of SDHs on CT or MRI in relation to time between trauma and scanning. Two researchers independently screened the articles, assessed methodological quality and performed data extraction. Medians with interquartile ranges were calculated. Differences were tested with a Mann-Whitney U or Kruskal-Wallis H test. RESULTS: We included 22 studies describing 973 SDHs on CT and 4 studies describing 83 SDHs on MRI. Data from 17 studies (413 SDHs) could be pooled. There were significant differences between time intervals for the different densities on CT (p<0.001). Time interval differed significantly between children and adults for iso- and hypodensity (p=0.000) and hyperdensity (p=0.046). Time interval did not differ significantly between abused and non-abused children. On MRI, time intervals for different signal intensities on T1 and T2 did not differ significantly (p=0.108 and p=0.194, respectively). CONCLUSIONS: Most time intervals of the different appearances of SDHs on CT and MRI are broad and overlapping. Therefore CT or MRI findings cannot be used to accurately date SDHs.
Authors: Nicole Berger; Lars C Ebert; Garyfalia Ampanozi; Patricia M Flach; Dominic Gascho; Michael J Thali; Thomas D Ruder Journal: Forensic Sci Med Pathol Date: 2015-01-08 Impact factor: 2.007
Authors: Daniel M Lindberg; Joanne N Wood; Kristine A Campbell; Philip V Scribano; Antoinette Laskey; John M Leventhal; Mary Clyde Pierce; Desmond K Runyan Journal: Child Abuse Negl Date: 2017-02-03