TABLE 2

Outcomes in Identified Cases in Which Diagnosis of Intracranial Hemorrhage Was Delayed (>6 Hours After Reported Injury)

TypeAgeGenderRisk FactorsSurgeryOutcome
Loss of ConsciousnessVomitingSeizureHeadacheSkull Fracture
DDIH with decreased level of consciousness7 yMaleNoUnknownYes (×1)YesYesYesDischarged, no significant sequelae
3 yFemaleUnknownNoUnknownUnknownNoYesDischarged, with substantial morbidity
DDIH without decreased level of consciousness13 yFemaleNoYes (×2)UnknownYesNoNoDischarged, no significant sequelae
6 yFemaleUnknownYes (×12)UnknownYesYesNoDischarged, no significant sequelae
11 yFemaleNoYes (×10)UnknownYesYesNoDischarged, no significant sequelae
7 yMaleNoYes (×3)UnknownUnknownNoNoDischarged, no significant sequelae
3 yFemaleNoYes (×3)UnknownYesNoNoDischarged, no significant sequelae
17 dMaleNoNoUnknownUnknownYesNoDischarged, no significant sequelae
4 yMaleNoYes (×6)UnknownYesNoNoDischarged, no significant sequelae
3 yMaleNoYes (×?)UnknownUnknownNoNoDischarged, no significant sequelae
NATa2 yMaleYesUnknownUnknownUnknownNoNoDeath
7 yMaleUnknownYes (×5)NoYesNoNoDischarged, no significant sequelae
6 moFemaleUnknownYes (×3)UnknownUnknownNoNoDischarged, no significant sequelae
2 yMaleUnknownNoUnknownUnknownNoNoDischarged, no significant sequelae
DIb4 yMaleNoYes (×6)UnknownYesNoNoDischarged, no significant sequelae
2 yMaleNoYes (×2)UnknownUnknownNoNoDischarged, no significant sequelae
ICH?c5 yMaleNoYes (×?)UnknownUnknownUnknownNoDischarged, no significant sequelae
  • DDIH indicates delayed diagnosis of intracranial hemorrhage; NAT, nonaccidental trauma; DI, delayed imaging; ICH, intracranial hemorrhage.

  • a Initial history findings provided by the parents suggested that the child had delayed diagnosis of intracranial hemorrhage, but subsequent evaluation revealed that the cause of brain injury was nonaccidental trauma, the timing of which was unclear.

  • b The potential for intracranial hemorrhage was recognized at <6 hours but imaging was delayed to >6 hours.

  • c Independent, blinded review by neurosurgeons suggested that the reported intracranial hemorrhage was attributable to an imaging artifact and did not represent true intracranial hemorrhage.