Differential diagnosis of pediatric intracranial trauma

Approach to the differential diagnosis of intracranial trauma:

  • Subgaleal hematoma is confined to subcutaneous tissues
  • Epidural hematoma is biconvex in shape
  • Subdural hematoma is crescent shaped
    Epidural and subdural hematomas cannot always be distinguished between and then are called extra-axial
  • Subarachnoid hemorrhage is in the subarachnoid space, can be mimicked by diffuse cerebral edema (pseudosubarachnoid hemorrhage)
  • Cerebral contusion is intraparenchymal hemorrhage, in coup / contra coup locations, variably sized
  • Diffuse axonal injury occurs at gray matter-white matter junction, is punctate, underestimated on CT
  • Diffuse cerebral edema causes cerebrum to be hypodense and thus the normal density of the cerebellum falsely appears hyperdense