뇌연화증이 초래된 Shaken Impact Syndrome 1례

A Case of Shaken Impact Syndrome with Encephalomalacia

본 저자들은 13개월 여아에서 아빠의 학대로 인하여 발생했을 것으로 추측되는 경막하 출혈과 의식 저하, 두개골 골절과 늑골 골절, 경막하 출혈 등이 발생하고 뇌연화증과 시력 상실, 영아 연축, 운동 장애를 보이는 shaken impact syndrome 1례를 경험하였기에 고찰과 함께 보고하는 바이다.

Head trauma is the most frequent cause of morbidity and death in abused children. The shaken impact syndroma results from both types of injury-impact and severs acceleration-deceleration effects associated with impact causing shearing forces on the bridging veins and parechyma. To make the diagnosis of shaken impact syndrome, the physician should be suspicious of every child under 1 year of age with non-accidental brain injury and altered consciousness. Certain clinical features such as retinal hemorrhage, complex, depressed, or diastatic fractures, and associated findings such as metaphyseal fracture and failure to thrive make the diagnosis of abuse more likely. Yet in the absence of these findings, the diagnosis of abuse rests upon discrepancies between the history given and the injury incurred. We experienced a case of shaken impact syndrome in a 13 month-old female who had subdural hemorrhage, fractures of skull and rib, and encephalomalacia, so we report and review the related literatures.