Difference between revisions of "Abusive head trauma"
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Revision as of 14:48, 25 March 2012
This article covers traumatic brain injury in infants that are suspected to be due to abuse, AKA shaken baby syndrome and shaken-impact syndrome.
Clinical triad[1]
- Retinal haemorrhage.
- Subdural hematoma (SDH).
- Acute encephalopathy.
- Some say brain swelling.[2]
Pathologic triad
- Subdural haemorrhage (SDH).
- May be "thin film" type.
- Retinal hemorrhage/nerve sheath hemorrhage.[3]
- Hypoxic encephalopathy.
Other features
Subcortical slit-like haemorrhages:[4][5]
- Classically frontal lobe.
- Shear force.
- Associated with shaken baby.
Related
Sinovenous thrombosis
- Usually not associated with SDH.
DDx:
- Coagulopathy.
- Trauma.
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.[6]
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.
- ↑ 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.
- ↑ 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.