Kachelski Cree, Gavin Kelsey, Head Hayden, Horton Danielle, Anderst James
Division of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Mayo Clinic Center for Safe and Healthy Children and Adolescents, Mayo Clinic, Rochester, MN, USA.
Graduate Medical Education, Children's Mercy Kansas City, Kansas City, MO, USA.
J Forensic Leg Med. 2024 Jan;101:102638. doi: 10.1016/j.jflm.2023.102638. Epub 2023 Dec 26.
Abusive head trauma (AHT) is a leading cause of abusive deaths in children under age one. AHT can include intracranial hemorrhages, hypoxic ischemic injury, or parenchymal lacerations. Most infants with parenchymal lacerations present with acute neurological symptoms. There has been some published literature on lucid intervals in cases of AHT; however, there has not been a described lucid interval with parenchymal lacerations. Parenchymal lacerations typically present with acute symptomatology such as seizures, alteration in mental status, or increased fussiness/lethargy given the damage to neurons and brain structure. We present a case of a healthy 2-month-old who ultimately was diagnosed with AHT and three parenchymal lacerations and had a 2.5 hour period of normal neurological status prior to acute decompensation.
虐待性头部创伤（AHT）是一岁以下儿童虐待致死的主要原因。AHT可包括颅内出血、缺氧缺血性损伤或实质撕裂伤。大多数患有实质撕裂伤的婴儿会出现急性神经症状。关于AHT病例中的清醒期已有一些文献发表；然而，尚未有关于实质撕裂伤清醒期的描述。鉴于神经元和脑结构受损，实质撕裂伤通常表现为急性症状，如癫痫发作、精神状态改变或烦躁/嗜睡加重。我们报告一例健康的2个月大婴儿，最终被诊断为AHT和三处实质撕裂伤，在急性失代偿前有2.5小时的神经状态正常期。
