{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:37:23Z","timestamp":1780317443517,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,8,19]],"date-time":"2018-08-19T00:00:00Z","timestamp":1534636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND AND PURPOSE<\/jats:title><jats:p>Hypoxic\u2010ischemic injuries (HIIs) are a scarcely investigated but important cause of morbidity and mortality in children who suffered abusive head trauma (AHT). The purpose of this study is to determine: (a) prevalence, types, and clinical relevance of cytotoxic edema compatible with HII in nonpenetrating AHT, (b) their relationship to other classic neuroimaging findings of AHT, and (c) their correlation with clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Diffusion\u2010weighted imaging sequences of magnetic resonance imagings performed on children under 5 years diagnosed with AHT were reviewed to detect the most common patterns of acute parenchymal damage. Patterns of cytotoxic edema were described, and HII\u2010compatible ones divided in subtypes. Correlation between HII, fractures, and subdural hemorrhages (SDHs) and with clinical outcomes was determined using imaging and available follow\u2010up data.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Out of 57 patients, 36.8% showed lesions compatible with HII. A predominantly asymmetric cortical distribution was observed in 66.7% of cases, while 33.3% had diffused both cortical and deep gray\/white matter distribution injury. Traumatic axonal injuries and focal contusions were less common. There was no significant correlation between the presence of SDH (<jats:italic>P<\/jats:italic> = .6) or skull fractures (<jats:italic>P<\/jats:italic> = .53) and HII. HII was the most severe form of parenchymal damage in terms of in\u2010hospital mortality and morbidity at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>HII is the most common type of parenchymal damage in children victim of AHT, being present in 1\/3 of patients with this condition, and correlates with more severe outcomes. Its presence is independent from other classic traumatic findings such as SDH and fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.12555","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T05:50:22Z","timestamp":1534744222000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Prevalence, Patterns, and Clinical Relevance of Hypoxic\u2010Ischemic Injuries in Children Exposed to Abusive Head Trauma"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6129-8061","authenticated-orcid":false,"given":"Emanuele","family":"Orru\u2019","sequence":"first","affiliation":[{"name":"Division of Neuroradiology, The Russell H. 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Morgan Department of Radiology and Radiological Science The Johns Hopkins School of Medicine  Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,19]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2003-1020-L"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.09.051"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-200505000-00006"},{"key":"e_1_2_5_5_1","unstructured":"National center for injury prevention and control.Rates of TBI\u2010related deaths by age Group \u2014 United States 2001\u20132010. Available at:https:\/\/www.cdc.gov\/traumaticbraininjury\/data\/rates_deaths_byage.html. 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