{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:15:30Z","timestamp":1762017330972},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2008,8]]},"abstract":"<jats:p>The authors describe the previously unreported occurrence of thoracolumbar subdural hematoma (SDH) resulting from nonaccidental trauma and emphasize the need for a complete and thorough neurological, physical, and radiological examination in all cases of suspected nonaccidental trauma.<\/jats:p>\n<jats:p>A 4-month-old male infant presented to the authors' Level 1 pediatric trauma center in respiratory arrest. According to the family, he had been previously healthy with a 1-day history of fussiness and irritability. While with one of the parents, the patient was noted to be apneic and had been shaken in 2 separate episodes in an attempt to stimulate respiration. Emergency services personnel intubated the child's trachea and transported him to the hospital. On arrival in the emergency department, the child was unresponsive and exhibited signs of myelopathy. A CT scan of his head demonstrated SDH and subarachnoid hemorrhage. Magnetic resonance imaging of the spine demonstrated an SDH dorsal to the spinal cord with some mass effect on the conus medullaris and descending nerve roots. The patient underwent emergency T-12 to L-3 laminotomies, evacuation of the hematoma, and laminoplasty.<\/jats:p>\n<jats:p>The rigid nature of the rib cage provides a point of fixation around which the thoracolumbar spine can hyperflex and hyperextend when shaken, resulting in severe injury to the bony, vascular, and neural elements of the spine.<\/jats:p>","DOI":"10.3171\/ped\/2008\/2\/8\/139","type":"journal-article","created":{"date-parts":[[2008,7,31]],"date-time":"2008-07-31T23:31:47Z","timestamp":1217547107000},"page":"139-142","source":"Crossref","is-referenced-by-count":14,"title":["Thoracolumbar spine subdural hematoma as a result of nonaccidental trauma in a 4-month-old infant"],"prefix":"10.3171","volume":"2","author":[{"given":"Thomas J.","family":"Gruber","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis J.","family":"Rozzelle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0020139","series-title":"Spine","doi-asserted-by":"publisher","first-page":"E388","DOI":"10.1097\/BRS.0b013e318067dcad","article-title":"Pediatric nonaccidental trauma thoracolumbar fracture-dislocation: posterior spinal fusion with pedicle screw fixation in an 8-month-old boy","volume":"32","author":"Bode","year":"2007"},{"key":"b2-0020139","series-title":"Am J Roentgen Rad Ther","first-page":"163","article-title":"Multiple fractures in the long bones of infants suffering from chronic subdural hematoma","volume":"56","author":"Caffey","year":"1946"},{"key":"b3-0020139","series-title":"Pediatr Emerg Care","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1097\/00006565-199404000-00005","article-title":"Child abuse presenting as a thoracolumbar spinal fracture dislocation: a case report","volume":"10","author":"Diamond","year":"1994"},{"key":"b4-0020139","series-title":"Child Abuse Negl","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/S0145-2134(96)00145-7","article-title":"Cervical spine MRI in abused infants","volume":"21","author":"Feldman","year":"1997"},{"key":"b5-0020139","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/S1042-3680(01)00002-X","article-title":"Pediatric spine and spinal cord injury after inflicted trauma","volume":"13","author":"Ghatan","year":"2002"},{"key":"b6-0020139","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1097\/BSD.0b013e31802c2ff6","article-title":"Traumatic subdural hematoma of the thoracolumbar junction of spinal cord","volume":"20","author":"Greiner-Perth","year":"2007"},{"key":"b7-0020139","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1227\/00006123-198904000-00008","article-title":"The infant whiplash-shake injury syndrome: a clinical and pathological study","volume":"24","author":"Hadley","year":"1989"},{"key":"b8-0020139","series-title":"Spine","doi-asserted-by":"publisher","first-page":"E534","DOI":"10.1097\/00007632-200212150-00024","article-title":"Traumatic spinal subdural hematoma with spontaneous resolution","volume":"27","author":"Hung","year":"2002"},{"key":"b9-0020139","series-title":"Invest Radiol","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1097\/00004424-199209000-00013","article-title":"Vertebral body fractures in child abuse. 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