Department of Radiology, Birmingham Children's Hospital, Birmingham, UK.
University College London Medical School, London, UK.
Pediatr Radiol. 2021 May;51(6):898-910. doi: 10.1007/s00247-021-04981-5. Epub 2021 Feb 27.
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?
虐待性头部创伤 (AHT) 的后果对儿童个体和整个社会都可能是毁灭性的。毫无疑问，死亡是一种非常现实的可能性，但即使是那些幸存下来的儿童，通常也会有非常严重的发病率，有可能出现严重的运动和认知障碍、行为问题、失明和癫痫，这会极大地影响他们的生活质量。照顾这些孩子给社会带来了巨大的经济和基础设施负担，这种负担常常会延伸到成年期。虽然很少有人对施虐者，通常是婴儿的父亲，表示同情，但应该指出的是，单一的、瞬间的完全失控可能会产生可怕的、无法预料的后果。本期的几篇论文描述了 AHT 的特征，包括颅骨骨折和脑外出血的描述，以及对这些现象的模拟。然而，在这篇综述中，我们集中关注可能发生的多种实质发现。这些实质损伤包括缺氧缺血性损伤、裂孔、挫伤和局灶性出血。我们对这些实体的现有思维提出了自己的看法，并将其置于一个非常重要的问题的背景下——我们如何识别虐待性头部创伤？
