Nishimoto Hiroshi
Department of Neurosurgery, Saitama Children's Medical Center, Iwatsuki, 2. Department of Neurosurgery, Kasukabe Municipital Hospital, Kasukabe, Saitama, Japan.
Neurol Med Chir (Tokyo). 2015;55(4):296-304. doi: 10.2176/nmc.ra.2014-0349. Epub 2015 Mar 23.
Head trauma is the leading cause of death in child abuse cases and one of the important issues in the care of abused children. Since the Child Abuse Prevention Law was enforced in 2000 in Japan, various measures have been taken to prevent child abuse over the following decade. Accordingly, medical research on abusive head trauma (AHT) has advanced, leading to significant progress in the medical diagnosis of AHT. This progress has been brought about by (1) the widespread establishment of child protection teams (CPTs) at core hospitals, (2) the progress in neuroradiological imaging and ophthalmoscopic technologies, and (3) the introduction of postmortem imaging. However, the pathological condition of patients with AHT, particularly that of the diffuse brain swelling type, still remains poorly understood. As a result, no clear treatment strategies for AHT have been developed and no treatment outcomes have been improved to date. The development of new treatment strategies for AHT and the construction of a comprehensive database that supports clinical studies are required in the future.
头部创伤是虐待儿童案件中的主要死因，也是受虐儿童护理中的重要问题之一。自2000年日本实施《儿童虐待预防法》以来，在接下来的十年里采取了各种措施来预防儿童虐待。因此，关于虐待性头部创伤（AHT）的医学研究取得了进展，在AHT的医学诊断方面取得了重大进展。这一进展是由以下因素促成的：（1）核心医院广泛设立儿童保护团队（CPT）；（2）神经放射成像和检眼镜技术的进步；（3）死后成像的引入。然而，AHT患者的病理状况，尤其是弥漫性脑肿胀型患者的病理状况，仍然知之甚少。因此，尚未制定出明确的AHT治疗策略，迄今为止治疗效果也没有得到改善。未来需要开发AHT的新治疗策略，并建立一个支持临床研究的综合数据库。
