BACKGROUND: Abusive @entity542 (AHT) is an important cause of serious @entity1545 in @entity1 and young @entity1 who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on @entity66 , both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these @entity66 represent primary cortical sinus and @entity49 that leads secondarily to @entity548 and secondary @entity1545 . @entity1244 has been reported at autopsy in AHT, but there has been no systematic study of @entity66 in cases of AHT. OBJECTIVE: The purpose of this study was to define the incidence and characteristics of venous and @entity50 in AHT. MATERIALS AND METHODS: We included all @entity1 <36  months of age who were diagnosed with abusive @entity542 between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on @entity66 . RESULTS: A total of 45 @entity1 were included. The median age was 3  months (range 15  days to 31  months) and 28 were @entity1 (62%). Clinical findings included @entity5861 in 71% and extracranial @entity174 in 55%. CT or MRI demonstrated @entity548 in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent @entity3439 or @entity4 . We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) @entity1 . CONCLUSION: Evidence of displacement or compression of cortical veins and sinuses from @entity548 or @entity4 on MR venography was present in the majority of @entity1 with abusive @entity542 . Evidence of direct trauma to the veins (lollipop sign) was identified in nearly half of cases. It is important to understand the superimposed effects of @entity3439 and @entity4 on the veins and sinuses to differentiate it from cortical sinus and @entity49 .

Venous injury in abusive XXXX .

@entity1545 :: ('MESH:D020214', 'Disease') :: ['brain injury'] @entity1 :: ('9606', 'Species') :: ['children', 'infants', 'boys'] @entity1244 :: ('MESH:D012852', 'Disease') :: ['Direct trauma to the veins and sinuses'] @entity3439 :: ('MESH:D006408', 'Disease') :: ['subdural hematoma'] @entity66 :: ('MESH:D004194', 'Disease') :: ['venous abnormalities', 'abnormalities involving the intracranial veins and venous sinuses', 'abnormalities of the cranial venous sinuses and cortical veins'] @entity548 :: ('MESH:D006470', 'Disease') :: ['subdural hemorrhage'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures'] @entity4 :: ('MESH:D004487', 'Disease') :: ['edema', 'brain swelling'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head trauma'] @entity49 :: ('MESH:D019851', 'Disease') :: ['venous thrombosis'] @entity5861 :: ('MESH:D012166', 'Disease') :: ['retinal hemorrhage'] @entity50 :: ('MESH:D012851', 'Disease') :: ['sinus abnormalities']
@entity542 :: (MESH:D006259,Disease) :: ['head trauma']
