Bird C R, McMahan J R, Gilles F H, Senac M O, Apthorp J S
Radiology. 1987 May;163(2):373-5. doi: 10.1148/radiology.163.2.3562816.
The central nervous system is commonly affected in child abuse. Between April 1985 and July 1986 three infants were identified in whom the primary mode of injury had been strangulation. In each case computed tomography (CT) demonstrated a large cerebral infarction confined to vascular territories associated with small subdural hematomas. There was no history or visible evidence of significant head trauma. Autopsy of one infant confirmed the presence of a hemispheric infarct, thin subdural hematoma, and an area of subintimal hemorrhage in the carotid artery ipsilateral to the infarct. The remaining two patients survived with residual hemiparesis. CT findings of a large cerebral infarction with an associated subdural hematoma in an infant without a history of a significant trauma should suggest the possibility of child abuse and may be the primary manifestation of abuse in some patients.
虐待儿童时中枢神经系统常受影响。1985年4月至1986年7月间，发现3名婴儿，其主要损伤方式为勒颈。每例计算机断层扫描（CT）均显示大片脑梗死，局限于与小的硬膜下血肿相关的血管区域。无明显头部外伤史或可见证据。对1名婴儿进行尸检，证实存在半球梗死、薄层硬膜下血肿以及梗死同侧颈动脉内膜下出血区域。其余2例患者存活，但有残留偏瘫。在无明显外伤史的婴儿中，CT显示大片脑梗死并伴有硬膜下血肿，应提示虐待儿童的可能性，且在某些患者中可能是虐待的主要表现。
