Difference between revisions of "Abusive head trauma"
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This article covers '''abusive head trauma''' in infants. It commonly goes by the name '''shaken baby syndrome''', abbreviated '''SBS'''. | This article covers '''abusive head trauma''' in infants. It commonly goes by the name '''shaken baby syndrome''', abbreviated '''SBS'''. A common alternate term is '''shaken-impact syndrome'''; this is advocated by some as it is uncertain shaking alone is sufficient to cause the classic pattern of injuries. | ||
==Defining features== | ==Defining features== | ||
| Line 12: | Line 12: | ||
#Subdural hemorrhage (SDH). | #Subdural hemorrhage (SDH). | ||
#*May be "thin film" type. | #*May be "thin film" type. | ||
#Retinal hemorrhage/nerve sheath hemorrhage.<ref name=pmid18936952>PMID 18936952 | #Retinal hemorrhage/nerve sheath hemorrhage.<ref name=pmid18936952>{{Cite journal | last1 = Matschke | first1 = J. | last2 = Püschel | first2 = K. | last3 = Glatzel | first3 = M. | title = Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury. | journal = Int J Legal Med | volume = 123 | issue = 3 | pages = 189-97 | month = May | year = 2009 | doi = 10.1007/s00414-008-0293-8 | PMID = 18936952 }}</ref> | ||
#Hypoxic encephalopathy. | #Hypoxic encephalopathy. | ||
===Other features=== | ===Other features=== | ||
Subcortical slit-like | Subcortical slit-like hemorrhages:<ref>URL: [http://books.google.com/books?id=0tZIcDDe6bAC&pg=PA481&lpg=PA481&dq=slit+white+matter+hemorrhage&source=bl&ots=1v-PVo2cmI&sig=HCnZBVYvyst8vC-ZcXL396pTrIk&hl=en&ei=oh2JTMy-NsSqlAf78qyBDg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBEQ6AEwADgK#v=onepage&q=slit%20white%20matter%20hemorrhage&f=false http://books.google.com/books?id=0tZIcDDe6bAC&pg=PA481&lpg=PA481&dq=slit+white+matter+hemorrhage&source=bl&ots=1v-PVo2cmI&sig=HCnZBVYvyst8vC-ZcXL396pTrIk&hl=en&ei=oh2JTMy-NsSqlAf78qyBDg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBEQ6AEwADgK#v=onepage&q=slit%20white%20matter%20hemorrhage&f=false]. Accessed on: 9 September 2010.</ref><ref>David Ramsay. 9 September 2010.</ref> | ||
*Classically frontal lobe. | *Classically frontal lobe. | ||
*Shear force. | *Shear force. | ||
*Associated with shaken baby. | *Associated with shaken baby syndrome. | ||
==Related== | ==Related== | ||
| Line 28: | Line 28: | ||
*Coagulopathy, as may be seen in sepsis. | *Coagulopathy, as may be seen in sepsis. | ||
*Trauma. | *Trauma. | ||
===Subcortical hemorrhage=== | |||
*Associated with cerebral vein thrombosis.<ref name=pmid7622677>{{Cite journal | last1 = Keiper | first1 = MD. | last2 = Ng | first2 = SE. | last3 = Atlas | first3 = SW. | last4 = Grossman | first4 = RI. | title = Subcortical hemorrhage: marker for radiographically occult cerebral vein thrombosis on CT. | journal = J Comput Assist Tomogr | volume = 19 | issue = 4 | pages = 527-31 | month = | year = | doi = | PMID = 7622677 }}</ref> | |||
===Blood work of shock=== | ===Blood work of shock=== | ||
Latest revision as of 18:02, 20 May 2013
This article covers abusive head trauma in infants. It commonly goes by the name shaken baby syndrome, abbreviated SBS. A common alternate term is shaken-impact syndrome; this is advocated by some as it is uncertain shaking alone is sufficient to cause the classic pattern of injuries.
Defining features
Clinical triad
Classically described as:[1]
- Retinal haemorrhage.
- Subdural hemorrhage (SDH).
- Acute encephalopathy.
- Some say brain swelling.[2]
Pathologic triad
- Subdural hemorrhage (SDH).
- May be "thin film" type.
- Retinal hemorrhage/nerve sheath hemorrhage.[3]
- Hypoxic encephalopathy.
Other features
Subcortical slit-like hemorrhages:[4][5]
- Classically frontal lobe.
- Shear force.
- Associated with shaken baby syndrome.
Related
Sinovenous thrombosis
- Usually not associated with SDH.
DDx:
- Coagulopathy, as may be seen in sepsis.
- Trauma.
Subcortical hemorrhage
- Associated with cerebral vein thrombosis.[6]
Blood work of shock
- Glucose - high (IV fluids).
- WBC - high.
- LFTs - high (ischemia).
- INR - high (dilutional).
- Hb - low (dilutional).
Neonatal giant cell hepatitis
Main article: Neonatal giant cell hepatitis
- Reported to be a cause of subdural hematoma.[7]
See also
References
- ↑ Oehmichen M, Schleiss D, Pedal I, Saternus KS, Gerling I, Meissner C (September 2008). "Shaken baby syndrome: re-examination of diffuse axonal injury as cause of death". Acta Neuropathol. 116 (3): 317–29. doi:10.1007/s00401-008-0356-4. PMID 18365221.
- ↑ David Ramsay. 9 September 2010.
- ↑ Matschke, J.; Püschel, K.; Glatzel, M. (May 2009). "Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury.". Int J Legal Med 123 (3): 189-97. doi:10.1007/s00414-008-0293-8. PMID 18936952.
- ↑ URL: http://books.google.com/books?id=0tZIcDDe6bAC&pg=PA481&lpg=PA481&dq=slit+white+matter+hemorrhage&source=bl&ots=1v-PVo2cmI&sig=HCnZBVYvyst8vC-ZcXL396pTrIk&hl=en&ei=oh2JTMy-NsSqlAf78qyBDg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBEQ6AEwADgK#v=onepage&q=slit%20white%20matter%20hemorrhage&f=false. Accessed on: 9 September 2010.
- ↑ David Ramsay. 9 September 2010.
- ↑ Keiper, MD.; Ng, SE.; Atlas, SW.; Grossman, RI.. "Subcortical hemorrhage: marker for radiographically occult cerebral vein thrombosis on CT.". J Comput Assist Tomogr 19 (4): 527-31. PMID 7622677.
- ↑ Guddat, SS.; Ehrlich, E.; Martin, H.; Tsokos, M. (Sep 2011). "Fatal spontaneous subdural bleeding due to neonatal giant cell hepatitis: a rare differential diagnosis of shaken baby syndrome.". Forensic Sci Med Pathol 7 (3): 294-7. doi:10.1007/s12024-011-9227-8. PMID 21331818.