乳児虐待による急性硬膜下血腫 ─15年間における臨床像の変化─

抄録

Background and Purpose: We investigated recent changes in clinical characteristics of acute subdural hematoma (ASDH) in abused infants.

Patients and Methods: In recent 5 years, we experienced 7 abused infants with ASDH (recent group). Clinical characteristics of infants were compared with other 6 abused infants with ASDH who were experienced between 10 and 15 years ago (previous group). Age, gender, assailants, methods of abuse, symptoms, sites of ASDHs, traumatic lesions other than head injuries, treatments, and outcome were reviewed from medical records to compare between groups.

Results: Most patients were male in late period of infancy, and were delayed in consulting to a medical doctor in both previous and recent groups. The most common assailant was mother in the previous group, although they were fathers or mothers' boy friends in the recent group. Being dropped or thrown was the most common cause of injury in the previous group, shaking was the most common in the recent group. Injuries on the body surface were common finding in the previous group, although they were rare in the recent group. As sites of subdural hematomas, supratentorial vault was the most common in the previous group, supratentorial interhemisphere was the most in the recent group. In chronic stage after ASDHs, severe brain atrophy was common in both groups, suggesting poor functional outcome.

Conclusion: Recent clinical characteristics of abused infantile ASDH was different from classical those in Japan, and were similar to those in Western countries.