儿科虐待性头部创伤的神经症状:临床法医学的多中心数据

IF 2.2 3区 医学 Q1 MEDICINE, LEGAL
Katharina Feld , Dustin Feld , Maria L. Hahnemann , Sibylle Banaschak , Heidi Pfeiffer , Bernd Karger , Daniel Wittschieber
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引用次数: 0

摘要

在虐待性头部创伤(AHT)病例中经常可以发现与中枢神经系统相关的病变。由于体表经常没有明显的受伤痕迹,因此诊断虐待性头部外伤具有挑战性。特别是,如果患儿仅表现出孤立的神经系统症状,往往会被误认为是小病。通过在三所大学医院进行回顾性研究,我们分析了 72 例 "婴儿摇晃综合征"(AHT 的一种常见变体)的医学法律案例。为了减少循环论证的风险,我们对供认病例(15 例)和非供认病例进行了比较。这些病例中最常见的神经系统症状是:癫痫发作(44%)、面色苍白(37%)、嗜睡(31%)、肌张力下降(25%)、呕吐(20%)和昏迷(15%)。供认与非供认病例之间,以及同时出现皮肤或骨骼病变的病例之间,也没有明显的统计学差异。几种症状的结合可作为出现 AHT 的一个指标,在临床观察中,如果假设存在 AHT,则应采取进一步的诊断措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neurological symptoms in pediatric abusive head trauma: Multi-center data for clinical forensic medicine
Central nervous system-associated lesions can frequently be found in abusive head trauma (AHT) cases. Since there are frequently no visible signs of injury on the body surface, the diagnosis of AHT can be challenging. In particular, if the affected child shows only isolated neurological symptoms, these are often misinterpreted as a minor illness. Using a retrospective study design at three university hospitals, 72 medico-legal cases of “shaken baby syndrome” – a common variant of AHT – were analyzed. A comparison between confession cases (n=15) and non-confession cases was used in order to reduce the risk of circular reasoning. The most common neurological symptoms in the present cases were: epileptic seizures (44 %), pallor (37 %), somnolence (31 %), reduced muscle tone (25 %), vomiting (20 %) and unconsciousness (15 %). There were also no statistically significant differences between confession and non-confession cases, nor when comparing the simultaneous presence of skin or skeletal lesions. The combination of several symptoms serves as an indicator for the presence of AHT and should lead to further diagnostic measures under the hypothesis of the presence of an AHT in clinical observation.
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来源期刊
Forensic science international
Forensic science international 医学-医学:法
CiteScore
5.00
自引率
9.10%
发文量
285
审稿时长
49 days
期刊介绍: Forensic Science International is the flagship journal in the prestigious Forensic Science International family, publishing the most innovative, cutting-edge, and influential contributions across the forensic sciences. Fields include: forensic pathology and histochemistry, chemistry, biochemistry and toxicology, biology, serology, odontology, psychiatry, anthropology, digital forensics, the physical sciences, firearms, and document examination, as well as investigations of value to public health in its broadest sense, and the important marginal area where science and medicine interact with the law. The journal publishes: Case Reports Commentaries Letters to the Editor Original Research Papers (Regular Papers) Rapid Communications Review Articles Technical Notes.
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