Hanigan W C, Peterson R A, Njus G
Department of Neurosciences, University of Illinois College of Medicine at Peoria.
Pediatrics. 1987 Nov;80(5):618-22.
An array of signs pathognomonic of child abuse is described for three young children. The eponym "tin ear syndrome" describes distinct unilateral ear bruising, radiographic evidence of ipisilateral cerebral edema with obliteration of the basilar cisterns, and hemorrhagic retinopathy. Rotational acceleration produced by blunt trauma to the ear is shown to be a necessary and sufficient cause for the production of this syndrome. An approximate value of 4,670 radians/s2 produced by a force of 309 to 347 N (70 to 80 lb) results in shear stress and tearing of the subdural veins, loss of cortical vasomotor tone, cerebral hyperemia, herniation, and death. Past history and environmental circumstances implicated child abuse in every case.
描述了三名幼儿身上一系列具有虐待儿童特征性的体征。“听力迟钝综合征”这一名称描述了明显的单侧耳部瘀伤、同侧脑水肿伴基底池闭塞的影像学证据以及出血性视网膜病变。耳部钝器伤产生的旋转加速度被证明是产生该综合征的必要且充分原因。由309至347牛（70至80磅）的力产生的约4670弧度/秒²的加速度会导致硬膜下静脉的剪切应力和撕裂、皮质血管运动张力丧失、脑充血、脑疝和死亡。在每一个病例中，既往史和环境情况都表明存在虐待儿童的行为。
