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Abstract
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The Centers for Disease Control and Prevention (CDC) defined that pediatric abusive head trauma (AHT) is an injury to the skull or intracranial contents of an infant or young child (<5 years of age) due to inflicted blunt impact and/or violent shaking. Unintentional injuries resulting from neglectful supervision and gunshot wounds/stab wounds/penetrating trauma should excluded.
In this issue, The Lee et al. presenting the pediatric AHT in the single trauma center. The total four cases under 12-month years old were described. This article reported the physical exam, image finding of brain, the clinical outcome of each cases. The three had the bi-lateral subdural hematoma (SDH), retinal hemorrhage in two, the periosteal reaction in one. In that cases, the caregiver's state minor head trauma but, there are more severe status than that. The clinical outcome is definitely poor in all case (the vegetative status In 2, the brain death in the 2).
The author described the characteristics of AHT distinguished from unintended head trauma in the discussion section. The first, In the fundus examination, retinal hemorrhages (RHs) is observed. The typical skull fracture in abuse child is bilaterality, the new and the old healed fracture were diagnosed together, and extra-cranial fracture may be watched (chest wall fracture exc.)
Frequently, the AHT may be concealed by the special relationship between patient and pediatrics. Also, the individual and society does not intend to be related the care and education of the another's child. The physician (doctor) has many opportunities to exam the AHT pediatrics in emergency room and out-patient clinic. They also could distinguish the AHT from the un-intended head trauma by the professional medical knowledge and experience. So, to the physician, it is emphasized to watch and report the child abuse as a good role of the society.
Child abuse causes indelible damage to a child. It is not only the physical also but the mental and psychological. In fact, many victims of child abuse often live with the aftereffects even after...
Language: en |