Skip to main content
Log in

Ursachen des Schädel-Hirn-Traumas im Kindesalter

Differenzierung zwischen akzidentellen und nichtakzidentellen Umständen

Cause of head injury in childhood

Differentiation between accidental and non-accidental mechanisms

  • Leitthema
  • Published:
Rechtsmedizin Aims and scope Submit manuscript

Zusammenfassung

Das Schädel-Hirn-Trauma ist die häufigste Ursache gewaltsamer Todesfälle im Kindesalter. Insbesondere die Differenzierung zwischen akzidentellen und nichtakzidentellen Ursachen ist von forensischer Bedeutung. Eine fundierte forensisch-neuropathologische Begutachtung kann nur unter Berücksichtigung der entwicklungsbedingten Besonderheiten vorgenommen werden. Anhand ausgewählter Befunde und Verletzungsbilder wird das Spektrum neurotraumatischer Veränderungen im Kindesalter beschrieben.

Abstract

Pediatric head injury is the most common cause of violent death in infancy. Of particular forensic importance is the differentiation between accidental and non-accidental mechanisms. A thorough forensic neuropathological examination must consider the unique differences that exist anatomically and developmentally in the young child. The broad spectrum of alterations in pediatric neurotrauma is presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10

Literatur

  1. Barone S, Das KP, Lassiter TL, White LD (2000) Vulnerable processes of nervous system development: a review of markers and methods. Neurotoxicology 21:15–36

    PubMed  CAS  Google Scholar 

  2. Byard RW, Bhatia KD, Reilly PL, Vink R (2009) How rapidly does cerebral swelling follow trauma? Observations using an animal model and possible implications in infancy. Legal Med 11:S128–S131

    Article  PubMed  Google Scholar 

  3. Case ME (2008) Inflicted traumatic brain injury in infants and young children. Brain Pathol 18:571–582

    Article  PubMed  Google Scholar 

  4. Case ME (2008) Accidental traumatic head injury in infants and young children. Brain Pathol 18:583–589

    Article  PubMed  Google Scholar 

  5. Case ME, Graham MA, Handy TC et al (2001) Position paper on fatal abusive head injuries in infants and young children. Am J Forensic Med Pathol 22:112–122

    Article  PubMed  CAS  Google Scholar 

  6. Downard C, Hulka F, Mullins RJ et al (2000) Relationship of cerebral perfusion pressure and survival in pediatric brain-injured patients. J Trauma 49:654–659

    Article  PubMed  CAS  Google Scholar 

  7. Dolinak D, Reichard RR (2006) An overview of inflicted head injury in infants and young children, with a review of β-amyloid precursor protein immunohistochemistry. Arch Pathol Lab Med 130:712–717

    PubMed  CAS  Google Scholar 

  8. Duhaime A-C, Gennarelli TA, Thibault LE et al (1987) The shaken baby syndrome. A clinical, pathological, and biomechanical study. J Neurosurg 66:409–415

    Article  PubMed  CAS  Google Scholar 

  9. Friede RL (1989) Developmental neuropathology, 2. Aufl. Springer, Berlin Heidelberg New York Tokio, S 1–25

  10. Geddes JF, Hackshaw AK, Vowles GH et al (2001) Neuropathology of inflicted head injury in children. I. Patterns of brain damage. Brain 124:1290–1298

    Article  PubMed  CAS  Google Scholar 

  11. Leestma J (2009) Forensic neuropathology. CRC, Boca Raton, S 561–617

  12. Lindenberg R, Freytag E (1969) Morphology of brain lesions from blunt trauma in early infancy. Arch Pathol Lab Med 87:298–305

    CAS  Google Scholar 

  13. Lonergan GJ, Baker AM, Morey MK, Boos SC (2003) From the archives of the AFIP. Child abuse: radiologic-pathologic correlation. Radiographics 23:811–845

    Article  PubMed  Google Scholar 

  14. Minns RA, Brown JK (2005) Shaken baby syndrome and other non-accidental head injuries in children. McKeith, London

  15. Mützel E, Penning R (2009) Aspekte der klinischen Rechtsmedizin bei Kindesmisshandlung und -vernachlässigung, insbesondere beim Schütteltrauma. In: Peschel O, Mützel E, Penning R (Hrsg) Das Kind in der Forensischen Medizin. Festschrift für Wolfgang Eisenmenger. ecomed Medizin, Landsberg, S 167–186

  16. Myhre MC, Grøgaard JB, Dyb GA et al (2007) Traumatic head injury in infants and toddlers. Acta Paediatr 96:1159–1163

    Article  PubMed  CAS  Google Scholar 

  17. Oehmichen M, Schleiss D, Pedal I et al (2008) Shaken baby syndrome: re-examination of diffuse axonal injury as cause of death. Acta Neuropathol 116:317–329

    Article  PubMed  Google Scholar 

  18. Oehmichen M, Auer R, König HG (2006) Forensic neuropathology and neurology. Springer, Berlin Heidelberg New York Tokio, S 405–521

  19. Reichard RR, White CLI, Hladik CL, Dolinak D (2003) Beta-amyloid precursor protein staining in nonaccidental central nervous system injury in pediatric autopsies. J Neurotrauma 20:347–355

    Article  PubMed  Google Scholar 

  20. Ruddick C, Ward Platt MP, De San Lazaro C (2010) Head trauma outcomes of verifiable falls in newborn babies. Arch Dis Child Fetal Neonatal Ed 95:F144–F145

    Article  PubMed  CAS  Google Scholar 

  21. Tzioumi D, Oates RK (1998) Subdural hematomas in children under 2 years. Accidental or inflicted? A 10-year experience. Child Abuse Negl 22:1105–1112

    Article  PubMed  CAS  Google Scholar 

  22. Vinchon M, Defoort-Dhellemmes S, Desurmont M, Dhellemmes P (2005) Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg 102 (Suppl 4):380–384

    PubMed  Google Scholar 

  23. Zimmerman RA, Bilaniuk LT (1994) Pediatric head trauma. Neuroimaging Clin N Am 4:349–366

    PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Büttner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Büttner, A., Penning, R. & Graw, M. Ursachen des Schädel-Hirn-Traumas im Kindesalter. Rechtsmedizin 21, 185–190 (2011). https://doi.org/10.1007/s00194-011-0751-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00194-011-0751-3

Schlüsselwörter

Keywords

Navigation