The incidence of spinal pathology in 18 children with non-accidental head injury was determined in a study at Nottingham University Hospitals, UK. Between 2000 and 2007 children with non-accidental head injury had MRI of brain and whole spine; the spine was examined routinely in all suspected cases after 2005. Spinal subdural hematoma occurred in 8 (44%) cases. It was clinically occult in all cases, usually thoracic or lumbar in location, and large in 6. All had supratentorial and infratentorial intracranial subdural hematomas. Three of the 8 patients with supratentorial subdurals had skull fractures. Follow-up MRI of the spine within 1 to 3 months in 6 of the 8 cases showed reduction in size of the spinal subdural in 5 and complete resolution in 1. [1]
COMMENT. A high incidence of occult spinal subdural hematoma is reported in children with non-accidental head injury and brain subdurals. Patients with suspected non-accidental head injury should receive MRI of brain and whole spine in all cases.