Department of Otorhinolaryngology, Aalesund Hospital, Alesund, Norway.
Penn State Hershey Medical Center, Department of Radiology, Hershey, PA, USA.
Acta Paediatr. 2021 Oct;110(10):2686-2694. doi: 10.1111/apa.15908. Epub 2021 May 20.
Thrombosis of bridging veins has been suggested to be a marker of bridging vein rupture, and thus AHT, in infants with subdural haematoma.
This is a non-systematic review based on Pubmed search, secondary reference tracking and authors' own article collections.
Radiological studies asserting that imaging signs of cortical vein thrombosis were indicative of traumatic bridging vein rupture were unreliable as they lacked pathological verification of either thrombosis or rupture, and paid little regard to medical conditions other than trauma. Autopsy attempts at confirmation of ruptured bridging veins as the origin of SDH were fraught with difficulty. Moreover, microscopic anatomy demonstrated alternative non-traumatic sources of a clot in or around bridging veins. Objective pathological observations did not support the hypothesis that a radiological finding of bridging vein thrombosis was the result of traumatic rupture by AHT. No biomechanical models have produced reliable and reproducible data to demonstrate that shaking alone can be a cause of bridging vein rupture.
There is no conclusive evidence supporting the hypothesis that diagnostic imaging showing thrombosed bridging veins in infants correlates with bridging vein rupture. Hence, there is no literature support for the use of thrombosis as a marker for AHT.
桥静脉血栓形成被认为是桥静脉破裂的标志物，因此也是伴有硬膜下血肿的婴儿中 AHT 的标志物。
这是一项基于 Pubmed 搜索、二级参考文献追踪和作者自己的文章收集的非系统性综述。
影像学研究表明皮质静脉血栓形成的影像学征象提示外伤性桥静脉破裂，但这些研究不可靠，因为它们缺乏对血栓形成或破裂的病理验证，并且几乎没有考虑创伤以外的其他情况。试图通过尸检来证实破裂的桥静脉是 SDH 的起源，这是困难的。此外，显微镜解剖学显示了桥静脉内或周围血栓形成的替代非创伤性来源。客观的病理观察并不支持这样一种假设，即影像学上发现桥静脉血栓形成是 AHT 导致外伤性破裂的结果。没有生物力学模型产生可靠和可重复的数据来证明仅仅摇晃就能导致桥静脉破裂。
没有确凿的证据支持这样一种假设，即影像学上显示婴儿有血栓形成的桥静脉与桥静脉破裂相关。因此，没有文献支持将血栓形成作为 AHT 的标志物。
