Nonaka Masahiro, Asai Akio
Department of Neurosurgery, Kansai Medical University, Hirakata, Japan.
J Korean Neurosurg Soc. 2022 May;65(3):380-384. doi: 10.3340/jkns.2021.0285. Epub 2022 Apr 28.
Subdural hematoma in infants can be caused by abuse, and is thought to be more likely if subdural hematoma is associated with retinal hemorrhage and cerebral edema. In Japan, few doctors disagree that cases of subdural hematoma with retinal hemorrhage and cerebral edema with multiple findings on the body are more likely to have been caused by abuse rather than by household accident. On the other hand, in cases where there are no other significant physical findings, only subdural hematoma and retinal hemorrhage, there is a difference of opinion as to whether the injury was caused by an accident or abuse. The reason for this is that neurosurgeons in Japan promoted the concept that infants can develop subdural hematomas and retinal hemorrages due to minor trauma at home before the concept of abusive head trauma became known. In addition, the age distribution of subdural hematomas in Japan differs from that in other countries, with peaks at around 8 months, and the reason for this remains unclear. Therefore, the etiology of infant subdural hematoma in Japan needs to be investigated in greater detail.
婴儿硬膜下血肿可能由虐待引起，并且如果硬膜下血肿与视网膜出血和脑水肿相关，则被认为更有可能是由虐待所致。在日本，几乎没有医生会不同意，伴有视网膜出血和脑水肿且身体有多处损伤的硬膜下血肿病例更有可能是由虐待而非家庭意外造成的。另一方面，在没有其他明显身体损伤、仅有硬膜下血肿和视网膜出血的病例中，对于损伤是由意外还是虐待造成的存在意见分歧。原因在于，在虐待性头部创伤的概念为人所知之前，日本的神经外科医生就提出了婴儿可能因家中轻微创伤而出现硬膜下血肿和视网膜出血的观点。此外，日本硬膜下血肿的年龄分布与其他国家不同，在8个月左右出现峰值，其原因尚不清楚。因此，日本婴儿硬膜下血肿的病因需要更详细地研究。
