RESUMO
BACKGROUND: Criteria for diagnosing abusive head trauma (AHT) or "shaken baby syndrome" are not well defined; consequently, these conditions might be diagnosed on failing premises. METHODS: The authors have collected a total of 28 infants, from the US (20) and Norway (8), suspected of having been violently shaken, and their caregivers had been suspected, investigated, prosecuted or convicted of having performed this action. Among 26 symptomatic infants, there were 18 boys (69%) and 8 girls (31%)-mean age 5.1 month, without age difference between genders. RESULTS: Twenty-one of 26 symptomatic children (81%) had a head circumference at or above the 90 percentile, and 18 had a head circumference at or above the 97 percentile. After macrocephaly, seizure was the most frequent initial symptom in 13 (50%) of the symptomatic infants. Seventeen (65%) of the symptomatic infants had bilateral retinal haemorrhages, and two had unilateral retinal haemorrhages. All infants had neuroimaging compatible with chronic subdural haematomas/hygromas as well as radiological characteristics compatible with benign external hydrocephalus (BEH). CONCLUSIONS: BEH with subdural haematomas/hygromas in infants may sometimes be misdiagnosed as abusive head trauma. Based on the authors' experience and findings of the study, the following measures are suggested to avoid this diagnostic pitfall: medical experts in infant abuse cases should be trained in recognising clinical and radiological BEH features, clinicians with neuro-paediatric experience should always be included in the expert teams and reliable information about the head circumference development from birth should always be available.
Assuntos
Maus-Tratos Infantis , Traumatismos Craniocerebrais , Hematoma Subdural Crônico , Hidrocefalia , Síndrome do Bebê Sacudido , Criança , Maus-Tratos Infantis/diagnóstico , Pré-Escolar , Traumatismos Craniocerebrais/diagnóstico , Diagnóstico Diferencial , Feminino , Hematoma Subdural Crônico/diagnóstico , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/etiologia , Lactente , Masculino , Síndrome do Bebê Sacudido/diagnósticoRESUMO
The article by Oh et al describes the EEG findings in a group of infants diagnosed with abusive head trauma but does not pay attention to the symptoms that triggered admission.
Assuntos
Maus-Tratos Infantis , Traumatismos Craniocerebrais , Criança , Humanos , Lactente , ConvulsõesAssuntos
Síndrome da Criança Espancada/complicações , Síndrome da Criança Espancada/patologia , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/patologia , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/patologia , Síndrome da Criança Espancada/diagnóstico , Traumatismos Craniocerebrais/diagnóstico , Diagnóstico Diferencial , Humanos , Lactente , Imageamento por Ressonância Magnética/métodos , MasculinoRESUMO
This article provides an imaging overview of several of the common central nervous system (CNS) infections. Neurologic clinicians who provide acute care for patients should be familiar with the range of imaging findings for patients with acute neurologic infections, including knowledge of the appropriate study and the best protocol and views to show the disorder, and the ability to properly interpret them. This requirement applies particularly for CNS infections, as in stroke, in which a rapid appreciation of the exact cause of a patient's infection may play a major role in reducing mortality and morbidity.
