Fickenscher Kristin A, Dean Julianne S, Mena David C, Green Brian A, Lowe Lisa H
Department of Radiology, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City, Kansas City, MO 64152, USA.
South Med J. 2010 Feb;103(2):121-5. doi: 10.1097/SMJ.0b013e3181c9944e.
To compare occult brain injuries on neuroimaging in clinically asymptomatic children under 20 months due to abusive versus accidental head trauma.
A retrospective review of 58 children under 20 months who underwent neuroimaging for possible abusive trauma was performed. The data collected were demographics, neurological signs/symptoms, imaging findings, and disposition (abusive or accidental).
The disposition of 31 subjects was abusive trauma and 27 were accidental. At presentation, 8/31(25.8%) children with abusive injury and 15/27(55.6%) with accidental injury were neurologically asymptomatic. Neuroimaging was abnormal in 6 of 8 (75.0%) asymptomatic children with abusive injury, and 13/15 (86.7%) children with accidental trauma. No significant (P = 0.59) difference in frequency of abnormal neuroimaging was seen between the asymptomatic abusive and accidental trauma groups.
Although victims of abusive trauma under 20 months of age are less often neurologically asymptomatic compared to accidental trauma victims, neuroimaging revealed a high rate of occult traumatic brain injury in both groups.
比较20个月以下因虐待性头部外伤与意外头部外伤导致的临床无症状儿童的神经影像学隐匿性脑损伤情况。
对58例20个月以下因可能存在虐待性创伤而接受神经影像学检查的儿童进行回顾性研究。收集的数据包括人口统计学资料、神经系统体征/症状、影像学检查结果及诊断（虐待性或意外性）。
31例诊断为虐待性创伤，27例为意外性创伤。就诊时，31例虐待性损伤儿童中有8例（25.8%）神经系统无症状，27例意外性损伤儿童中有15例（55.6%）神经系统无症状。8例无症状虐待性损伤儿童中有6例（75.0%）神经影像学检查异常，15例意外性创伤儿童中有13例（86.7%）神经影像学检查异常。无症状虐待性创伤组与意外性创伤组神经影像学检查异常频率无显著差异（P = 0.59）。
虽然20个月以下虐待性创伤受害者与意外性创伤受害者相比，神经系统无症状者较少，但神经影像学检查显示两组隐匿性创伤性脑损伤发生率均较高。
