Journal of Korean Neurosurgical Society

  • 제65권3호
  • /
  • Pages.385-396
  • /
  • 2022
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Complex Pathophysiology of Abusive Head Trauma with Poor Neurological Outcome in Infants

  • Park, Young Soo (Department of Neurosurgery and Children's Medical Center, Nara Medical University)
  • 투고 : 2021.11.24
  • 심사 : 2022.02.07
  • 발행 : 2022.05.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Abusive head trauma (AHT) in infants, especially acute subdural hematoma, has an extremely poor outcome. The most decisive and important finding is the appearance of a widespread low-density area on head computed tomography. This phenomenon was traditionally thought to be caused by cerebral ischemia. However, many other pathophysiological abnormalities have been found to be intricately involved. Recent studies have found that status epilepticus and hyperperfusion injures are the major causes. Another serious problem associated with AHT is cardiopulmonary arrest (CPA). Many infants are reported to visit to the hospital with CPA, and its pathophysiology has not been fully elucidated. This paper examines the background of these pathological conditions and associated factors and elucidate the pathophysiological mechanisms resulting in poor outcomes in AHT. In addition to the intensity of assault on the head, the peculiar pathophysiological characteristics in infants, as well as the social background specific to child abuse, are found to be associated with poor outcome.

키워드

참고문헌

  1. Abu Hamdeh S, Marklund N, Lewen A, Howells T, Raininko R, Wikstrom J, et al. : Intracranial pressure elevations in diffuse axonal injury: association with nonhemorrhagic MR lesions in central mesencephalic structures. J Neurosurg 131 : 604-611, 2018 https://doi.org/10.3171/2018.4.jns18185
  2. Adams JH, Doyle D, Ford I, Gennarelli TA, Graham DI, McLellan DR : Diffuse axonal injury in head injury: definition, diagnosis and grading. Histopathology 15 : 49-59, 1989 https://doi.org/10.1111/j.1365-2559.1989.tb03040.x
  3. Adamsbaum C, Grabar S, Mejean N, Rey-Salmon C : Abusive head trauma: judicial admissions highlight violent and repetitive shaking. Pediatrics 126 : 546-555, 2010 https://doi.org/10.1542/peds.2009-3647
  4. Altman RL, Canter J, Patrick PA, Daley N, Butt NK, Brand DA : Parent education by maternity nurses and prevention of abusive head trauma. Pediatrics 128 : e1164-e1172, 2011 https://doi.org/10.1542/peds.2010-3260
  5. Arndt DH, Lerner JT, Matsumoto JH, Madikians A, Yudovin S, Valino H, et al. : Subclinical early posttraumatic seizures detected by continuous EEG monitoring in a consecutive pediatric cohort. Epilepsia 54 : 1780-1788, 2013 https://doi.org/10.1111/epi.12369
  6. Brown RL, Brunn MA, Garcia VF : Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center. J Pediatr Surg 36 : 1107-1114, 2001 https://doi.org/10.1053/jpsu.2001.25665
  7. Choudhary AK, Servaes S, Slovis TL, Palusci VJ, Hedlund GL, Narang SK, et al. : Consensus statement on abusive head trauma in infants and young children. Pediatr Radiol 48 : 1048-1065, 2018 https://doi.org/10.1007/s00247-018-4149-1
  8. Christian CW, Block R; Committee on Child Abuse and Neglect; American Academy of Pediatrics : Abusive head trauma in infants and children. Pediatrics 123 : 1409-1411, 2009 https://doi.org/10.1542/peds.2009-0408
  9. Colombari M, Troakes C, Turrina S, Tagliaro F, De Leo D, Al-Sarraj S : Spinal cord injury as an indicator of abuse in forensic assessment of abusive head trauma (AHT). Int J Legal Med 135 : 1481-1498, 2021 https://doi.org/10.1007/s00414-021-02526-x
  10. Cordobes F, Lobato RD, Rivas JJ, Portillo JM, Sarabia M, Munoz MJ : Post-traumatic diffuse brain swelling: isolated or associated with cerebral axonal injury. Clinical course and intracranial pressure in 18 children. Childs Nerv Syst 3 : 235-238, 1987 https://doi.org/10.1007/BF00274055
  11. Costine-Bartell BA, McGuone D, Price G, Crawford E, Keeley KL, MunozPareja J, et al. : Development of a model of hemispheric hypodensity ("big black brain"). J Neurotrauma 36 : 815-833, 2019 https://doi.org/10.1089/neu.2018.5736
  12. Dias MS, Rottmund CM, Cappos KM, Reed ME, Wang M, Stetter C, et al. : Association of a postnatal parent education program for abusive head trauma with subsequent pediatric abusive head trauma hospitalization rates. JAMA Pediatr 171 : 223-229, 2017 https://doi.org/10.1001/jamapediatrics.2016.4218
  13. Dias MS, Smith K, DeGuehery K, Mazur P, Li V, Shaffer ML : Preventing abusive head trauma among infants and young children: a hospitalbased, parent education program. Pediatrics 115 : e470-e477, 2005 https://doi.org/10.1542/peds.2004-1896
  14. Duhaime AC, Bilaniuk L, Zimmerman R : The "big black brain": radiographic changes after severe inflicted head injury in infancy. J Neurotrauma 10(Suppl 1) : S59, 1993
  15. Duhaime AC, Christian C, Moss E, Seidl T : Long-term outcome in infants with the shaking-impact syndrome. Pediatr Neurosurg 24 : 292-298, 1996 https://doi.org/10.1159/000121058
  16. Duhaime AC, Christian CW : Abusive head trauma: evidence, obfuscation, and informed management. J Neurosurg Pediatr 24 : 481-488, 2019 https://doi.org/10.3171/2019.7.PEDS18394
  17. Duhaime AC, Christian CW, Rorke LB, Zimmerman RA : Nonaccidental head injury in infants--the "shaken-baby syndrome". N Engl J Med 338 : 1822-1829, 1988
  18. Duhaime AC, Durham S : Traumatic brain injury in infants: the phenomenon of subdural hemorrhage with hemispheric hypodensity ("big black brain"). Prog Brain Res 161 : 293-302, 2007 https://doi.org/10.1016/S0079-6123(06)61020-0
  19. Eder HG, Legat JA, Gruber W : Traumatic brain stem lesions in children. Childs Nerv Syst 16 : 21-24, 2000 https://doi.org/10.1007/s003810050005
  20. Figueira Rodrigues Vieira G, Guedes Correa JF : Early computed tomography for acute post-traumatic diffuse axonal injury: a systematic review. Neuroradiology 62 : 653-660, 2020 https://doi.org/10.1007/s00234-020-02383-2
  21. Foster KA, Recker MJ, Lee PS, Bell MJ, Tyler-Kabara EC : Factors associated with hemispheric hypodensity after subdural hematoma following abusive head trauma in children. J Neurotrauma 31 : 1625-1631, 2014 https://doi.org/10.1089/neu.2014.3372
  22. Gennarelli TA, Thibault LE, Adams JH, Graham DI, Thompson CJ, Marcincin RP : Diffuse axonal injury and traumatic coma in the primate. Ann Neurol 12 : 564-574, 1982 https://doi.org/10.1002/ana.410120611
  23. Gerber P, Coffman K : Nonaccidental head trauma in infants. Childs Nerv Syst 23 : 499-507, 2007 https://doi.org/10.1007/s00381-006-0267-4
  24. Graupman P, Winston KR : Nonaccidental head trauma as a cause of childhood death. J Neurosurg 104(4 Suppl) : 245-250, 2006
  25. Greeley CS : Abusive head trauma: a review of the evidence base. AJR Am J Roentgenol 204 : 967-973, 2015 https://doi.org/10.2214/AJR.14.14191
  26. Greiner MV, Greiner HM, Care MM, Owens D, Shapiro R, Holland K : Adding insult to injury: nonconvulsive seizures in abusive head trauma. J Child Neurol 30 : 1778-1784, 2015 https://doi.org/10.1177/0883073815580285
  27. Hasbani DM, Topjian AA, Friess SH, Kilbaugh TJ, Berg RA, Christian CW, et al. : Nonconvulsive electrographic seizures are common in children with abusive head trauma*. Pediatr Crit Care Med 14 : 709-715, 2013 https://doi.org/10.1097/PCC.0b013e3182917b83
  28. Karibe H, Kameyama M, Hayashi T, Narisawa A, Tominaga T : Acute subdural hematoma in infants with abusive head trauma: a literature review. Neurol Med Chir (Tokyo) 56 : 264-273, 2016 https://doi.org/10.2176/nmc.ra.2015-0308
  29. Khan NR, Fraser BD, Nguyen V, Moore K, Boop S, Vaughn BN, et al. : Pediatric abusive head trauma and stroke. J Neurosurg Pediatr 20 : 183-190, 2017 https://doi.org/10.3171/2017.4.PEDS16650
  30. Kim HJ : The prognostic factors related to traumatic brain stem injury. J Korean Neurosurg Soc 51 : 24-30, 2012 https://doi.org/10.3340/jkns.2012.51.1.24
  31. Lee WJ, Lim YC, Yoon SH : Abusive head traumas in 4 infants. Korean J Neurotrauma 16 : 246-253, 2020 https://doi.org/10.13004/kjnt.2020.16.e30
  32. Mata-Mbemba D, Mugikura S, Nakagawa A, Murata T, Ishii K, Kushimoto S, et al. : Traumatic midline subarachnoid hemorrhage on initial computed tomography as a marker of severe diffuse axonal injury. J Neurosurg 129 : 1317-1324, 2018 https://doi.org/10.3171/2017.6.jns17466
  33. Mata-Mbemba D, Mugikura S, Nakagawa A, Murata T, Kato Y, Tatewaki Y, et al. : Intraventricular hemorrhage on initial computed tomography as marker of diffuse axonal injury after traumatic brain injury. J Neurotrauma 32 : 359-365, 2015 https://doi.org/10.1089/neu.2014.3453
  34. Moen KG, Brezova V, Skandsen T, Haberg AK, Folvik M, Vik A : Traumatic axonal injury: the prognostic value of lesion load in corpus callosum, brain stem, and thalamus in different magnetic resonance imaging sequences. J Neurotrauma 31 : 1486-1496, 2014 https://doi.org/10.1089/neu.2013.3258
  35. Narang SK, Estrada C, Greenberg S, Lindberg D : Acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. J Pediatr 177 : 273-278, 2016 https://doi.org/10.1016/j.jpeds.2016.06.036
  36. Narang SK, Fingarson A, Lukefahr J; COUNCIL ON CHILD ABUSE AND NEGLECT : Abusive head trauma in infants and children. Pediatrics 145 : e20200203, 2020 https://doi.org/10.1542/peds.2020-0203
  37. O'Neill BR, Handler MH, Tong S, Chapman KE : Incidence of seizures on continuous EEG monitoring following traumatic brain injury in children. J Neurosurg Pediatr 16 : 167-176, 2015 https://doi.org/10.3171/2014.12.PEDS14263
  38. Onuma T, Shimosegawa Y, Kameyama M, Arai H, Ishii K : Clinicopathological investigation of gyral high density on computerized tomography following severe head injury in children. J Neurosurg 82 : 995-1001, 1995 https://doi.org/10.3171/jns.1995.82.6.0995
  39. Paek D, Kwon DI : A review on four different paths to respiratory arrest from brain injury in children; implications for child abuse. J Forensic Leg Med 71 : 101938, 2020 https://doi.org/10.1016/j.jflm.2020.101938
  40. Pang D : Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery 55 : 1325-1342; discussion 1342-1343, 2004 https://doi.org/10.1227/01.neu.0000143030.85589.e6
  41. Pang D, Wilberger JE Jr : Spinal cord injury without radiographic abnormalities in children. J Neurosurg 57 : 114-129, 1982 https://doi.org/10.3171/jns.1982.57.1.0114
  42. Piteau SJ, Ward MG, Barrowman NJ, Plint AC : Clinical and radiographic characteristics associated with abusive and nonabusive head trauma: a systematic review. Pediatrics 130 : 315-323, 2012 https://doi.org/10.1542/peds.2011-1545
  43. Rongchao S, Shudong Y, Zhiyi Z : Pathological and immunohistochemical study of lethal primary brain stem injuries. Diagn Pathol 7 : 54, 2012 https://doi.org/10.1186/1746-1596-7-54
  44. Visocchi M, Chiaretti A, Genovese O, Di Rocco F : Haemodynamic patterns in children with posttraumatic diffuse brain swelling. A preliminary study in 6 cases with neuroradiological features consistent with diffuse axonal injury. Acta Neurochir (Wien) 149 : 347-356, 2007 https://doi.org/10.1007/s00701-006-1102-0
  45. Wong AM, Yeh CH, Liu HL, Wu TW, Lin KL, Wang HS, et al. : Arterial spin-labeling perfusion imaging of children with subdural hemorrhage: perfusion abnormalities in abusive head trauma. J Neuroradiol 44 : 281-287, 2017 https://doi.org/10.1016/j.neurad.2017.02.003
  46. Yokobori S, Nakae R, Yokota H, Spurlock MS, Mondello S, Gajavelli S, et al. : Subdural hematoma decompression model: a model of traumatic brain injury with ischemic-reperfusional pathophysiology: a review of the literature. Behav Brain Res 15 : 23-28, 2018
  47. Zimmerman RA, Bilaniuk LT, Farina L : Non-accidental brain trauma in infants: diffusion imaging, contributions to understanding the injury process. J Neuroradiol 34 : 109-114, 2007 https://doi.org/10.1016/j.neurad.2007.01.124