caa a22 4500 463180739 CHVBK 20180406164838.0 cr unu---uuuuu 170326e20070501xx s 000 0 eng 10.1007/s00381-006-0267-4 doi (NATIONALLICENCE)springer-10.1007/s00381-006-0267-4 Nonaccidental head trauma in infants [Elektronische Daten] [Paula Gerber, Kathryn Coffman] Background: Nonaccidental head trauma in infants is the leading cause of infant death from injury. Results and discussion: Clinical features that suggest inflicted head trauma include the triad of the so-called shaken baby syndrome, consisting of retinal hemorrhage, subdural, and/or subarachnoid hemorrhage in an infant with little signs of external trauma. Studies have shown that, in general, the average short fall in the home is extremely unlikely to produce either subdural or retinal hemorrhage, although focal injuries such as skull fractures and epidural hemorrhage may be seen. Acceleration/deceleration, especially of the rotational type, is believed to be the most probable mechanism of injury in cases of nonaccidental head trauma. Damage to the cervicomedullary junction and the respiratory centers, with subsequent hypoxia and intracerebral edema, has also been implicated. After the initial trauma and hemorrhage, loss of cerebral autoregulation, breakdown of the blood-brain barrier, and disruption of ionic homeostasis occur, leading to brain edema and cytotoxicity. Cellular damage can involve large volumes of tissue, without respecting vascular territories. Conclusion: Overall, a satisfactory biomechanical model is lacking, and the criminal nature of abusive injury makes it difficult to perform systematic, controlled studies. Unfortunately, outcomes are poor, and the rate of repeated abusive episodes is high. Future research should focus on the development of a satisfactory research model and on prevention strategies. Springer-Verlag, 2007 Abuse nationallicence Children nationallicence Shaken baby syndrome nationallicence Nonaccidental trauma nationallicence Gerber Paula Barrow Neurological Institute, 8th floor, 350 W. Thomas Rd., 85013, Phoenix, AZ, USA aut Coffman Kathryn Child Abuse Assessment Center, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA aut Child's Nervous System Springer-Verlag 23/5(2007-05-01), 499-507 0256-7040 23:5<499 2007 23 381 https://doi.org/10.1007/s00381-006-0267-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-006-0267-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gerber Paula Barrow Neurological Institute, 8th floor, 350 W. Thomas Rd., 85013, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Coffman Kathryn Child Abuse Assessment Center, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/5(2007-05-01), 499-507 0256-7040 23:5<499 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer