Parenchymal brain injuries in abusive head trauma
Parenchymal brain injuries in abusive head trauma
复制标题
虐待性头部创伤中的实质脑损伤
DOI：
10.1007/s00247-021-04981-5
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发表时间：
2021
影响因子：
2.3
通讯作者：
K. Mankad
中科院分区：
文献类型：
--
作者：
A. Oates;J. Sidpra;K. Mankad
虐待性头部创伤（AHT）的后果对儿童个人和更广泛的社会来说都可能是毁灭性的。死亡无疑是一种非常真实的可能性，但即使是那些幸存下来的儿童，也往往有非常严重的发病率，可能出现严重的运动和认知障碍、行为问题、失明和癫痫，这会大大影响他们的生活质量。照顾这些儿童给社会带来巨大的财政和基础设施负担，这种负担往往延续到成年。虽然很少有人会努力对肇事者（通常是婴儿的父亲）产生任何同情，但应该指出的是，一个单独的、短暂的完全失控可能会产生可怕的、不可预见的后果。这一版中的一些论文描述了AHT的特征，包括颅骨骨折和轴外出血的描述，沿着这些现象的模拟。然而，在这篇综述中，我们将注意力集中在可能发生的无数实质性发现上。这种实质损伤包括缺氧缺血性损伤、裂口、挫伤和局灶性出血。我们提供了我们对这些实体的当前思维的观点，并将它们放在非常重要的问题的背景下-我们如何识别虐待性头部创伤？
The consequences of abusive head trauma (AHT) can be devastating for both the individual child and for wider society. Death is undoubtedly a very real possibility, but even for those children who survive, there is often very significant morbidity with the potential for gross motor and cognitive impairment, behavioural problems, blindness and epilepsy, which can greatly affect their quality of life. Caring for such children places a vast financial and infrastructural burden on society that frequently extends well into adulthood. While few struggle to have any sympathy for the perpetrator, frequently the infant’s father, it should be noted that a single solitary and momentary loss of complete control can have horrific and unforeseen consequences. A number of papers within this edition describe features of AHT and include descriptions of skull fractures and extra-axial haemorrhage, along with mimics of such phenomena. However, in this review we concentrate our attention on the myriad of parenchymal findings that can occur. Such parenchymal injuries include hypoxic–ischaemic damage, clefts, contusion and focal haemorrhage. We offer our perspectives on current thinking on these entities and put them in the context of the immensely important question — how do we recognise abusive head trauma?