Differential diagnosis of pediatric intracranial trauma

• Subgaleal hematoma
• Skull fracture
• Epidural hematoma
• Subdural hematoma
• Subarachnoid hemorrhage
• Cerebral contusion
• Diffuse axonal injury
• Cerebral hemorrhage
• Cerebral laceration
• Intraventricular hemorrhage
• Diffuse cerebral edema

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