Difference between revisions of "Abusive head trauma"

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*Subdural haemorrhage (SDH).
*Subdural haemorrhage (SDH).
**May be "thin film" type.
**May be "thin film" type.
*Nerve sheath hemorrhage<ref name=pmid18936952>PMID 18936952.</ref> (pathologic correlate to retinal hemorrhage).
*Retinal hemorrhage/nerve sheath hemorrhage.<ref name=pmid18936952>PMID 18936952.</ref>
*???
*Hypoxic encephalopathy.


===Other features===
===Other features===

Revision as of 20:42, 6 October 2010

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]

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).


See also

References

  1. 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.
  2. David Ramsay. 9 September 2010.
  3. PMID 18936952.
  4. 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.
  5. David Ramsay. 9 September 2010.